Significant underestimation of preventive effects in colorectal cancer screening trial

Morgan et al recently pointed out that, while colorectal cancer (CRC) remains a highly frequent cancer worldwide, trends in CRC incidence are decreasing markedly in some countries,1 which may largely be attributed to endoscopic screening.2 We; therefore, read with great interest the recently published follow-up results of the Nordic-European Initiative on Colorectal Cancer (NordICC) trial, suggesting a presumably smaller than expected protective effect of screening colonoscopy to prevent CRC. After 10-year follow-up, CRC incidence was reduced by 18% in the intention-to-screen analysis, comparing the intervention versus the control group, and by 31% in the per-protocol analyses, comparing participants screened versus controls.3 However, there is a strong reason to assume that the reported incidence reduction is significantly underestimated. In randomised screening endoscopy trials,3–8 the measured incidence shows an initial apparent increase in...
Source: Gut - Category: Gastroenterology Authors: Tags: Open access, Gut PostScript Source Type: research