https://www.crcprevention.eu/res/file/presentations2013/2013-02-vanleerdam.pdf

Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(10)62110-1.pdf

Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)61720-0.pdf

Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials

The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer.

https://www.gastrojournal.org/article/S0016-5085(10)00961-3/pdf

CLINICAL—ALIMENTARY TRACT The Reduction in Colorectal Cancer Mortality After Colonoscopy Varies by Site of the Cancer

A study was carried out to investigate the change in stage at presentation of patients with colorectal cancer over 10 years. Cases were identified from the control group of subjects enrolled into a randomized controlled study based on Haemoccult screening for colorectal neoplasia. Of 405 subjects in the control group (presenting with symptomatic colorectal cancer, 206 presented before 1989 and 199 since then. The number of patients with Dukes' stage A carcinoma diagnosed since 1989 rose from 21 (10.4 per cent) to 35 (18.1 per cent); this change occurred for rectosigmoid tumours (9.9 per cent before 1989, 28 per cent after 1989) but not for colonic cancer (10.9 per cent before 1989, 11.5 per cent thereafter). An increase in the proportion of patients with symptomatic early-stage rectosigmoid cancer has been observed in the past 10 years. No such change occurred in those with colonic cancer. This may reflect a change in awareness of te disease and its symptoms by patients and general practitioners.

Change towards earlier stage at presentation of colorectal cancer.

Cause specific mortality statistics derived from death certificates are highly dependent upon the accuracy of certification by the attending physician. In the Nottingham colorectal cancer screening trial, there were 12,624 deaths among the screening group and 12,515 among the control group during the period under consideration. There was no significant difference in all cause mortality rate (excluding deaths due to colorectal cancer) between the two study groups (rate ratio = 1.01, 95% confidence interval = 0.99 to 1.03). Disease specific mortality rates did not differ significantly between the two groups either. Overall, the agreement between verified and certified cause of death was 86%. Using the certified cause of death would have resulted in an underestimation bias of 6.27% for colorectal cancer deaths.

C. M. Mangham

Papers

Change towards earlier stage at presentation of colorectal cancer.

Faecal occult blood screening for colorectal cancer at Nottingham: details of the verification process.