Abstract
Screening is an established strategy for reducing death from colorectal cancer. The availability of multiple guidelines-recommended for colorectal cancer increases the complexity of screening decision-making for patients, clinicians and policy makers. This is compounded by differences in the strength of the evidence supporting the use of currently available tests in actual clinical practice. Therefore, colorectal cancer screening represents an important focus for comparative effectiveness research: the available tests also vary in cost, complexity and risk of complications.
Another unique situation with colorectal cancer screening is the increasing use of colonoscopy for screening, the effectiveness of which has been recently called into question, while tests with proven efficacy such as sigmoidoscopy and fecal-based tests are now less frequently used. This presentation will discuss colorectal cancer comparative effectiveness research from the context of an NCI-funded project. The specific aim of that project is to estimate the effectiveness of screening colonoscopy in reducing death from colorectal cancer among average risk adults when compared to no screening. Of particular interest is to determine if colonoscopy is effective in reducing death from right-sided colon cancers and to examine the impact of quality of colonoscopy on its effectiveness.
The presentation will discuss the following concerning colorectal cancer screening comparative effectiveness research: 1) the disconnect between health care policies, clinical practice and scientific evidence; 2) the methodological challenges of studying the comparative effectiveness of colorectal cancer screening tests; and 3) review the design of the funded observational study.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B114.
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