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dc.contributor.authorKindt, Isabella Skaarup
dc.contributor.authorMartiny, Frederik Handberg Juul
dc.contributor.authorGram, Emma Grundtvig
dc.contributor.authorBie, Anne Katrine Lykke
dc.contributor.authorJauernik, Christian Patrick
dc.contributor.authorRahbek, Or Joseph
dc.contributor.authorNielsen, Sigrid Brisson
dc.contributor.authorSiersma, Volkert
dc.contributor.authorBang, Christine Winther
dc.contributor.authorBrodersen, John Brandt
dc.date.accessioned2024-01-03T13:03:27Z
dc.date.available2024-01-03T13:03:27Z
dc.date.issued2023-10-31
dc.description.abstractIntroduction - Physical harm from Colorectal Cancer Screening tends to be inadequately measured and reported in clinical trials. Also, studies of ongoing Colorectal Cancer Screening programs have found more frequent and severe physical harm from screening procedures, e.g., bleeding and perforation, than reported in previous trials. Therefore, the objectives of the study were to systematically review the evidence on the risk of bleeding and perforation in Colorectal Cancer Screening.<p> <p>Design - Systematic review with descriptive statistics and random-effects meta-analyses.<p> <p>Methods - We systematically searched five databases for studies investigating physical harms related to Colorectal Cancer Screening. We assessed the internal and the external validity using the ROBINS-I tool and the GRADE approach. Harm estimates was calculated using mixed Poisson regression models in random-effect meta-analyses.<p> <p>Results - We included 89 studies. Reporting and measurement of harms was inadequate in most studies. In effect, the risk of bias was critical in 97.3% and serious in 98.3% of studies. All GRADE ratings were very low. Based on severe findings with not-critical risk of bias and 30 days follow-up, the risk of bleedings per 100,000 people screened were 8 [2;24] for sigmoidoscopy, 229 [129;408] for colonoscopy following fecal immunochemical test, 68 [39;118] for once-only colonoscopy, and 698 [443;1045] for colonoscopy following any screening tests. The risk of perforations was 88 [56;138] for colonoscopy following fecal immunochemical test and 53 [25;112] for once-only colonoscopy. There were no findings within the subcategory severe perforation with long-term follow-up for colonoscopy following any screening tests and sigmoidoscopy.<p> <p>Discussion - Harm estimates varied widely across studies, reporting and measurement of harms was mostly inadequate, and the risk of bias and GRADE ratings were very poor, collectively leading to underestimation of harm. In effect, we consider our estimates of perforation and bleeding as conservative, highlighting the need for better reporting and measurement in future studies.en_US
dc.identifier.citationKindt, Martiny, Gram, Bie, Jauernik, Rahbek, Nielsen, Siersma, Bang, Brodersen. The risk of bleeding and perforation from sigmoidoscopy or colonoscopy in colorectal cancer screening: A systematic review and meta-analyses. PLOS ONE. 2023;18(10)
dc.identifier.cristinIDFRIDAID 2203621
dc.identifier.doi10.1371/journal.pone.0292797
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/10037/32298
dc.language.isoengen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.journalPLOS ONE
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleThe risk of bleeding and perforation from sigmoidoscopy or colonoscopy in colorectal cancer screening: A systematic review and meta-analysesen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Med mindre det står noe annet, er denne innførselens lisens beskrevet som Attribution 4.0 International (CC BY 4.0)