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AIM:To conduct a systematic review and meta-analysis of published population-based randomized controlled trials(RCTs).METHODS:RCTs evaluating the difference in mortality and incidence of colorectal cancer(CRC)between a screening flexible sigmoidoscopy(FS)group and control group(not assigned to screening FS)with a minimum 5 years median follow-up were identified by a search of MEDLINE and EMBASE databases and the Cochrane Central Register for Controlled Trials through August 2013.Random effects model was used for meta-analysis.RESULTS:Four RCTs with a total of 165659 patientsin the FS group and 249707 patients in the control group were included in meta-analysis.Intention-totreat analysis showed that there was a 22%risk reduction in total incidence of CRC(RR=0.78,95%CI:0.74-0.83),31%in distal CRC incidence(RR=0.69,95%CI:0.63-0.75),and 9%in proximal CRC incidence(RR=0.91,95%CI:0.83-0.99).Those who underwent screening FS were 18%less likely to be diagnosed with advanced CRC(OR=0.82,95%CI:0.71-0.94).There was a 28%risk reduction in overall CRC mortality(RR=0.72,95%CI:0.65-0.80)and 43%in distal CRC mortality(RR=0.57,95%CI:0.45-0.72).CONCLUSION:This meta-analysis suggests that screening FS can reduce the incidence of proximal and distal CRC and mortality from distal CRC along with reduction in diagnosis of advanced CRC.
AIM: To conduct a systematic review and meta-analysis of published population-based randomized controlled trials (RCTs). METHODS: RCTs evaluating the difference in mortality and incidence of colorectal cancer (CRC) between a screening flexible sigmoidoscopy (FS) group and control group (not assigned to screening FS) with a minimum 5 years median follow-up were identified by a search of MEDLINE and EMBASE databases and the Cochrane Central Register for Controlled Trials through August 2013. Random effects model was used for meta-analysis .RESULTS : Four RCTs with a total of 165659 patients in the FS group and 249707 patients in the control group were included in meta-analysis.Intention-totreat analysis showed that there was a 22% risk reduction in total incidence of CRC (RR = 0.78, 95 % CI: 0.74-0.83), 31% in distal CRC incidence (RR = 0.69, 95% CI: 0.63-0.75), and 9% in proximal CRC incidence (RR = 0.91, 95% CI: 0.83-0.99) who underwent screening FS were 18% less likely to be diagnosed with advanced CRC (OR = 0.82, 95% CI: 0 .71-0.94). There was a 28% reduction in overall CRC mortality (RR = 0.72, 95% CI: 0.65-0.80) and 43% in distal CRC mortality (RR = 0.57, 95% CI: 0.45-0.72) .CONCLUSION: This meta-analysis suggests that screening FS can reduce the incidence of proximal and distal CRC and mortality from distal CRC along with reduction in diagnosis of advanced CRC.