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22 August 2017

Reanalysis of All-Cause Mortality in the U.S. Preventive Services Task Force 2016 Evidence Report on Colorectal Cancer Screening

Authors: Andrew W. Swartz, MD, Jan M. Eberth, PhD, Michele J. Josey, MS, and Scott M. Strayer, MDAuthor, Article, & Disclosure Information
Publication: Annals of Internal Medicine
Volume 167, Number 8
https://doi.org/10.7326/M17-0859
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Background: The 2016 U.S. Preventive Services Task Force (USPSTF) evidence report on colorectal cancer screening concluded that no colorectal cancer screening methods reduce all-cause mortality. This conclusion was partially based on a meta-analysis of 4 randomized trials that compared flexible sigmoidoscopy screening with no screening. The meta-analysis aggregated results from the 2 age cohorts of 1 of the trials—the NORCCAP (Norwegian Colorectal Cancer Prevention) study—as if these cohorts were a single trial (1). Aggregation of outcomes that have markedly different event rates, screening–control ratios, or both can create a Simpson paradox, a phenomenon where a finding exists in individual …

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References

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Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 167 • Number 8 • 17 October 2017
Pages: 602 - 603

History

Published online: 22 August 2017
Published in issue: 17 October 2017

Keywords

  1. Cancer prevention
  2. Cancer screening
  3. Cohort studies
  4. Colorectal cancer
  5. Colorectal cancer screening
  6. Flexible sigmoidoscopy
  7. Lung and intrathoracic tumors
  8. Mortality
  9. Ovarian cancer
  10. Relative risk

Copyright

© 2017 American College of Physicians.

Authors

Affiliations

Andrew W. Swartz, MD
From Yukon-Kuskokwim Delta Regional Hospital, Bethel, Alaska, and University of South Carolina, Columbia, South Carolina.
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Jan M. Eberth, PhD
From Yukon-Kuskokwim Delta Regional Hospital, Bethel, Alaska, and University of South Carolina, Columbia, South Carolina.
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Michele J. Josey, MS
From Yukon-Kuskokwim Delta Regional Hospital, Bethel, Alaska, and University of South Carolina, Columbia, South Carolina.
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Scott M. Strayer, MD
From Yukon-Kuskokwim Delta Regional Hospital, Bethel, Alaska, and University of South Carolina, Columbia, South Carolina.
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Disclaimer: No entity other than the authors had any input or role in the design, execution, composition, or decision to publish.
Acknowledgment: The authors thank Olga Y. Gorlova, PhD (Geisel School of Medicine, Dartmouth University), and Gloria Ann Evans, FNP, DrPH (retired, Durham, North Carolina), for critical manuscript review and stylistic suggestions and Karen Matthias (Anchorage, Alaska) for stylistic suggestions.
Financial Support: Dr. Eberth is supported in part by a Mentored Research Scholar Grant from the American Cancer Society (MRSG-15-148-01-CPHPS). Ms. Josey is supported in part by grant T32-GM081740 from the National Institutes of Health, National Institute of General Medical Sciences.
This article was published at Annals.org on 22 August 2017.

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Andrew W. Swartz, Jan M. Eberth, Michele J. Josey, et al. Reanalysis of All-Cause Mortality in the U.S. Preventive Services Task Force 2016 Evidence Report on Colorectal Cancer Screening. Ann Intern Med.2017;167:602-603. [Epub 22 August 2017]. doi:10.7326/M17-0859

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