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Colorectal Screening is Associated with Reduced Colorectal Cancer Risk: A Case–Control Study within the Population-Based Ontario Familial Colorectal Cancer Registry

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Abstract

Objective:

This is the first study to evaluate the association between colonic screening and colorectal cancer risk among Canadians.

Methods:

A case–control study was conducted. Cases were diagnosed with cancer of the colorectum, between 1997 and 2000, aged 20 to 74 years, identified through the population-based Ontario Cancer Registry and recruited by the Ontario Familial Colorectal Cancer Registry. Controls were a sex- and age-matched random sample of the population of Ontario. 971 cases and 1944 controls completed questionnaires (including colorectal screening history and many risk factors). Multivariate logistic regression analysis was used to obtain adjusted odds ratios (OR) estimates.

Results:

Having had a fecal occult blood screen was associated with reduced colorectal cancer risk (OR=0.76; 95% confidence interval (CI): 0.59, 0.97). Having had a screening sigmoidoscopy was associated with a halving of colorectal cancer risk (OR = 0.52; 95% CI: 0.34, 0.80). Having had a screening colonoscopy did not significantly reduce colorectal cancer risk (OR = 0.69; 95% CI: 0.44, 1.07); however, having had either screening endoscopy was associated with a significant reduction in colorectal cancer risk (OR = 0.62; 95% CI: 0.44, 0.87). Findings differed slightly by anatomic sub-site (proximal and distal colorectum).

Conclusions:

We report a reduction in colorectal cancer risk among persons who underwent colorectal cancer screening; in particular, sigmoidoscopy. Findings are of great importance for the prevention of colorectal cancer.

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References

  • National Cancer Institute of Canada (NCIC) (2003) Canadian Cancer Statistics 2003, Toronto, Canada

  • McLaughlin JR, Sloan M, Janovjak D (1995) Cancer Survival in Ontario. The Ontario Cancer Treatment and Research Foundation

  • JS Mandel TR Church JH Bond et al. (2000) ArticleTitleThe effect of fecal occult-blood screening on the incidence of colorectal cancer NEJM 343 1603–1607 Occurrence Handle10.1056/NEJM200011303432203 Occurrence Handle11096167

    Article  PubMed  Google Scholar 

  • ML Slattery SL Edwards KN Ma GD Friedman (2000) ArticleTitleColon cancer screening, lifestyle, and risk of colon cancer Cancer Causes Control 11 555–563 Occurrence Handle10.1023/A:1008924115604 Occurrence Handle10880038

    Article  PubMed  Google Scholar 

  • O Kronborg C Fenger J Olsen O Jorgensen O Sondergaard (1996) ArticleTitleRandomised study of screening for colorectal cancer with faecal occult blood test Lancet 348 1467–1471 Occurrence Handle10.1016/S0140-6736(96)03430-7 Occurrence Handle8942774

    Article  PubMed  Google Scholar 

  • JS Mandel TR Church F Ederer JH Bond (1999) ArticleTitleColorectal cancer mortality: effectiveness of biennial screening for fecal occult blood J Natl Cancer Inst 91 434–437 Occurrence Handle10.1093/jnci/91.5.434 Occurrence Handle10070942

    Article  PubMed  Google Scholar 

  • JD Hardcastle JO Chamberlain MH Robinson et al. (1996) ArticleTitleRandomised controlled trial for faecal-occult-blood screening for colorectal cancer Lancet 348 1472–1477 Occurrence Handle10.1016/S0140-6736(96)03386-7 Occurrence Handle8942775

    Article  PubMed  Google Scholar 

  • AM Kavanagh EL Giovannucci CS Fuchs GA Colditz (1998) ArticleTitleScreening endoscopy and risk of colorectal cancer in United States men Cancer Causes Control 9 455–462 Occurrence Handle10.1023/A:1008884021049 Occurrence Handle9794179

    Article  PubMed  Google Scholar 

  • A Muller A Sonnenberg (1995) ArticleTitlePrevention of colorectal cancer by flexible endoscopy and polypectomy. A case–control study of 32,702 veterans Ann Intern Med 123 904–10 Occurrence Handle7486484

    PubMed  Google Scholar 

  • H Brenner V Arndt T Sturmer C Stegmaier H Ziegler G Dhom (2001) ArticleTitleLong lasting reduction of risk of colorectal cancer following screening endoscopy Br J Cancer 85 972–976 Occurrence Handle10.1038/sj.bjc.6692023 Occurrence Handle11592768

    Article  PubMed  Google Scholar 

  • P Newcomb B Storer L Morimoto A Templeton J Potter (2003) ArticleTitleLong-term efficacy of sigmoidoscopy in the reduction of colorectal cancer incidence J Natl Cancer Inst 95 622–625 Occurrence Handle12697855

    PubMed  Google Scholar 

  • E Thiis-Evensen G Hoff J Sauar et al. (1999) ArticleTitlePopulation-based surveillance by colonoscopy: effect on the incidence of colorectal cancer Telemark Polyp Study I. Scand J Gastroenterol 34 414–420

    Google Scholar 

  • M Cotterchio G McKeown-Eyssen H Sutherland et al. (2000) ArticleTitleOntario Familial Colon Cancer Registry: Methods and First Year Response Rates Chron Dis Canada 21 81–86

    Google Scholar 

  • InstitutionalAuthorNameInternational Classification of Diseases. (1977) Manual of the International Statistical Classification of Disease, Injuries, and Causes of Death, 9th Revision Conference World Health Organization Geneva, Switzerland

    Google Scholar 

  • EJ Holowaty G Lee D Dale N Chong (1994) A reabstraction study to estimate the accuracy and completeness of data elements in the Ontario Cancer Registry American Association of Central Cancer Registries Niagara-on-the-Lake, Ontario

    Google Scholar 

  • HFA Vasen JP Mecklin PM Khan HT Lynch (1991) ArticleTitleThe international collaborative group on HNPCC Dis Colon Rectum 34 424–425 Occurrence Handle10.1007/BF02053699 Occurrence Handle2022152

    Article  PubMed  Google Scholar 

  • A Easson M Cotterchio D Dale E Holowaty S Gallinger (2002) The accuracy of site specific coding for colorectal cancer in a provincial cancer registry North American Association of Cancer Registries Meeting Toronto

    Google Scholar 

  • JJ Schlesselman (1982) Case–control studies. Design, conduct, analysis Oxford University Press Oxford

    Google Scholar 

  • G Maldonado S Greenland (1993) ArticleTitleSimulation study by confounder-selection strategies Am J Epidemiol 138 923–936 Occurrence Handle8256780

    PubMed  Google Scholar 

  • S Greenland (1989) ArticleTitleModeling and variable selection in epidemiologic analysis Am J Public Health 79 340–349 Occurrence Handle2916724

    PubMed  Google Scholar 

  • G Colditz K Atwood E Emmons R Monson W Willett et al. (2000) ArticleTitleHarvard Report on Cancer Prevention. Volume 4: Harvard Cancer Risk Index Cancer Causes Control 11 477–488 Occurrence Handle10.1023/A:1008984432272 Occurrence Handle10880030

    Article  PubMed  Google Scholar 

  • B Iacopetta (2002) ArticleTitleAre there two sides to colorectal cancer? Int J Cancer 101 403–408 Occurrence Handle10.1002/ijc.10635 Occurrence Handle12216066

    Article  PubMed  Google Scholar 

  • P Distler P Holt (1997) ArticleTitleAre right- and left-sided colon neoplasms distinct tumors? Dig Dis 15 302–311 Occurrence Handle9359018

    PubMed  Google Scholar 

  • B Bressler L Paszat C Vinden C Li J He L Rabeneck (2004) ArticleTitleColonoscopic miss rates for right-sided colon cancer: a population-based analysis Gastroenterol 127 452–456 Occurrence Handle10.1053/j.gastro.2004.05.032

    Article  Google Scholar 

  • S Winawer A Zauber M Ho et al. (1993) ArticleTitlePrevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup N Engl J Med 329 1977–81 Occurrence Handle10.1056/NEJM199312303292701 Occurrence Handle8247072

    Article  PubMed  Google Scholar 

  • M Slattery S Edwards W Samowitz (1998) ArticleTitleStage of colon cancer at diagnosis: implications for risk factor associations? Int J Epidemiol 27 382–387 Occurrence Handle10.1093/ije/27.3.382 Occurrence Handle9698124

    Article  PubMed  Google Scholar 

  • M Baier N Calonge G Cutter et al. (2000) ArticleTitleValidity of self-reported colorectal cancer screening behavior Cancer Epidemiol Biomarkers Prev 9 229–232 Occurrence Handle10698488

    PubMed  Google Scholar 

  • L Madlensky J McLaughlin V Goel (2003) ArticleTitleA comparison of self-reported colorectal cancer screening with medical records Cancer Epidemiol Biomarkers Prev 12 656–659 Occurrence Handle12869407

    PubMed  Google Scholar 

  • Colorectal Cancer Screening: Recommendation statement from the Canadian Task Force on Preventative Health Care. (2001) Can Med Assoc J 165: 206–208

    Google Scholar 

  • RA Smith V Cokkinidess HJ Eyre (2004) ArticleTitleAmerican Cancer Society guidelines for the early detection of cancer, 2004 CA Cancer J Clin 54 41–52 Occurrence Handle14974763

    PubMed  Google Scholar 

  • Institute of Clinical Evaluative Sciences (ICES). (2004) Vinden C, Schultz S, Rabeneck L. Use of Large Bowel Procedures in Ontario

  • L Rabeneck L Paszat (2004) ArticleTitleA population-based estimate of the extent of colorectal cancer screening in Ontario Am J Gastroenterol 99 1141–1144 Occurrence Handle10.1111/j.1572-0241.2004.30623.x Occurrence Handle15180738

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (CDC) (2001) Trends in Screening for colorectal cancer-United States, 1997 and 1999. JAMA 285: 1570–1571

    Google Scholar 

  • Centers for Disease Control and Prevention (CDC) (2003) Colorectal cancer test use among persons aged >50 years-United States, 2001. Morbidity and Mortality Weekly Report. March 14, 52(1): 193–196

    Google Scholar 

  • FA Anderson KZ Guyton Hiatt RA SW Vernon B Levin E Hawk (2002) ArticleTitleColorectal Cancer Screening for Persons at Average Risk J Natl Cancer Inst 94 1126–1133 Occurrence Handle12165637

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Preventive Oncology, Cancer Care Ontario, 620 University Avenue, M5G 2L7, Ontario, Toronto, Canada

    Michelle Cotterchio & Neil Klar

  2. Department of Public Health Sciences, University of Toronto, Ont., Toronto, Canada

    Michelle Cotterchio, Neil Klar & John McLaughlin

  3. Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Ont., Toronto, Canada

    Michael Manno, John McLaughlin & Steven Gallinger

Authors
  1. Michelle Cotterchio
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  2. Michael Manno
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  3. Neil Klar
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  4. John McLaughlin
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  5. Steven Gallinger
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Corresponding author

Correspondence to Michelle Cotterchio.

Additional information

*Financial Support – This work was supported by the National Cancer Institute, National Institutes of Health under RFA # CA-95-011 (grant no. U01-CA74783).

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Cotterchio, M., Manno, M., Klar, N. et al. Colorectal Screening is Associated with Reduced Colorectal Cancer Risk: A Case–Control Study within the Population-Based Ontario Familial Colorectal Cancer Registry. Cancer Causes Control 16, 865–875 (2005). https://doi.org/10.1007/s10552-005-2370-3

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  • DOI: https://doi.org/10.1007/s10552-005-2370-3

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