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@ARTICLE{Brenner:289654,
      author       = {H. Brenner$^*$ and T. Heisser$^*$ and R. Cardoso$^*$ and M.
                      Hoffmeister$^*$},
      title        = {{T}he underestimated preventive effects of flexible
                      sigmoidoscopy screening: re-analysis and meta-analysis of
                      randomized trials.},
      journal      = {European journal of epidemiology},
      volume       = {39},
      number       = {7},
      issn         = {0393-2990},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V.},
      reportid     = {DKFZ-2024-00836},
      pages        = {743-751},
      year         = {2024},
      note         = {#EA:C070#LA:C070# / 2024 Jul;39(7):743-751},
      abstract     = {Flexible sigmoidoscopy (FS), which is less invasive,
                      resource intensive and costly than colonoscopy, is among the
                      recommended screening options for colorectal cancer (CRC).
                      Four large randomized trials consistently reported
                      statistically significant, albeit modest effects of
                      screening by FS on CRC incidence. However, their effect
                      estimates included cancers that were already prevalent at
                      recruitment and could not have been prevented by screening.
                      We performed a re-analysis and meta-analysis of two of the
                      trials (including the largest one) to estimate reduction of
                      truly incident cases by a single FS offered between 55 and
                      64 years of age among the 'at risk study population' without
                      prevalent CRC at recruitment. In meta-analyses of data
                      reported after more than 15 years of follow-up, relative
                      risk $(95\%$ CI) in intention-to-screen and per-protocol
                      analyses were 0.71 (0.66-0.76) and 0.59 (0.55-0.65) for any
                      CRC, and 0.52 (0.47-0.57) and 0.34 (0.30-0.39) for distal
                      CRC, respectively. These results indicate much stronger
                      effects than those suggested by the original reports and
                      imply that a single screening FS can prevent approximately
                      two out of three distal incident CRC cases within 15 + years
                      of follow-up.},
      keywords     = {Colorectal cancer (Other) / Flexible sigmoidoscopy (Other)
                      / Incidence (Other) / Risk (Other) / Screening (Other) /
                      Trials (Other)},
      cin          = {C070 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38642235},
      doi          = {10.1007/s10654-024-01120-w},
      url          = {https://inrepo02.dkfz.de/record/289654},
}