Abstract:
OBJECTIVE: To compare the effectiveness of flexible sigmoidoscopy in screening for colorectal cancer by patient sex and age. DESIGN: Pooled analysis of randomised trials (the US Prostate, Lung, Colorectal and Ovarian cancer screening trial (PLCO), the Italian Screening for Colon and Rectum trial (SCORE), and the Norwegian Colorectal Cancer Prevention trial (NORCCAP)). DATA SOURCES: Aggregated data were pooled from each randomised trial on incidence of colorectal cancer and mortality stratified by sex, age at screening, and colon subsite (distal v proximal). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Invited individuals aged 55-74 (PLCO), 55-64 (SCORE), and 50-64 (NORCCAP). Individuals were randomised to receive flexible sigmoidoscopy screening once only (SCORE and NORCCAP) or twice (PLCO), or receive usual care (no intervention). RESULTS: 287 928 individuals were included in the pooled analysis; 115 139 randomised to screening and 172 789 to usual care. Compliance rates were 58%, 63%, and 87% in SCORE, NORCCAP, and PLCO, respectively. Median follow-up was 10.5 to 12.1 years. Screening reduced the incidence of colorectal cancer in men (relative risk 0.76; 95% confidence interval 0.70 to 0.83) and women (0.83; 0.75 to 0.92). No difference in the effect of screening was seen between men younger than 60 and those older than 60. Screening reduced the incidence of colorectal cancer in women younger than 60 (relative risk 0.71; 95% confidence interval 0.59 to 0.84), but not significantly in those aged 60 or older (0.90; 0.80 to 1.02). Colorectal cancer mortality was significantly reduced in both younger and older men, and in women younger than 60. Screening reduced colorectal cancer incidence to a similar extent in the distal colon in men and women, but there was no effect of screening in the proximal colon in older women with a significant interaction between sex and age group (P=0.04). CONCLUSION: Flexible sigmoidoscopy is an effective tool for colorectal cancer screening in men and younger women. The benefit is smaller and not statistically significant for women aged over 60; alternative screening methods that more effectively detect proximal tumours should be considered for these women.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Holme Ø,Schoen RE,Senore C,Segnan N,Hoff G,Løberg M,Bretthauer M,Adami HO,Kalager Mdoi
10.1136/bmj.i6673subject
Has Abstractpub_date
2017-01-13 00:00:00pages
i6673eissn
0959-8138issn
1756-1833journal_volume
356pub_type
杂志文章,meta分析abstract:OBJECTIVES:To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. DESIGN:Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39049.706493.55
更新日期:2007-01-13 00:00:00
abstract::The aim of the study was to determine the outcome in 181 diabetic patients with advanced, previously untreated renal impairment who had been identified in a survey conducted in six health regions in the United Kingdom in 1985. Late in 1987 questionnaires were sent to the consultant physicians, geriatricians, and nephr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6708.1135
更新日期:1989-11-04 00:00:00
abstract:OBJECTIVES:To identify risk factors predisposing to the development of flucloxacillin associated jaundice. DESIGN:Case-control study. Medical records of cases and controls were reviewed and information recorded on standard data collection forms. SETTING:Alfred Hospital recruiting subjects from Melbourne, Sydney, and ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6872.233
更新日期:1993-01-23 00:00:00
abstract:OBJECTIVES:To document the extent to which maternity data are collected and how they are recorded, and to identify problems that may affect their availability throughout the NHS. METHODS:Postal survey in September 1997 with structured questionnaires. SETTING:207 NHS trusts with maternity units in England. PARTICIPAN...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7210.619
更新日期:1999-09-04 00:00:00
abstract::Several forces have resulted in the creation in Tayside of the first formally integrated unit of undergraduate and postgraduate education in general practice in the United Kingdom. Forces that helped this integration included the desire for change, national developments in education, financial support through funds se...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6994.1577
更新日期:1995-06-17 00:00:00
abstract:OBJECTIVE:To study the dynamic function of hypothalamic 5-hydroxytryptamine receptors in patients with postviral fatigue syndrome. DESIGN:Prospective comparison of patients with postviral fatigue syndrome with two control groups. SETTING:Department of neurology, University of Glasgow, Southern General Hospital; depar...
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pub_type: 杂志文章
doi:10.1136/bmj.304.6833.1010
更新日期:1992-04-18 00:00:00
abstract:OBJECTIVES:To identify the genetic determinants of fracture risk and assess the role of 15 clinical risk factors on osteoporotic fracture risk. DESIGN:Meta-analysis of genome wide association studies (GWAS) and a two-sample mendelian randomisation approach. SETTING:25 cohorts from Europe, United States, east Asia, an...
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pub_type: 杂志文章,meta分析
doi:10.1136/bmj.k3225
更新日期:2018-08-29 00:00:00
abstract:OBJECTIVE:To investigate the facilities for inpatient care of mentally disordered people in prison. DESIGN:Semistructured inspections conducted by doctor and nurse. Expected standards were based on healthcare quality standards published by the Prison Service or the NHS. SETTING:13 prisons with inpatient beds in Engla...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.320.7241.1031
更新日期:2000-04-15 00:00:00
abstract:OBJECTIVES:To evaluate the use of a maternity unit run by general practitioners and midwives, describing the outcome of labour in an unselected group of women and quantifying the contribution made by general practitioners. DESIGN:Retrospective population based review of obstetric patients who had access to an isolated...
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pub_type: 杂志文章
doi:10.1136/bmj.312.7025.223
更新日期:1996-01-27 00:00:00
abstract:OBJECTIVE:To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence. DESIGN:Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and...
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doi:10.1136/bmj.315.7106.449
更新日期:1997-08-23 00:00:00
abstract:OBJECTIVES:Analysis of incidence and characteristics of congenital abdominal wall defects, with special reference to the differences between the incidence of gastroschisis and exomphalos (omphalocele). DESIGN:Retrospective analysis using data from the Office of Population Censuses and Surveys (recoded to differentiate...
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pub_type: 杂志文章
doi:10.1136/bmj.313.7062.903
更新日期:1996-10-12 00:00:00
abstract:OBJECTIVE:To assess the association of lichen planus with liver complaints and with known aetiological factors of liver diseases. DESIGN:Multicentre case-control study. Interviews were conducted by trained medical investigators on the basis of a structured questionnaire. At the interview patients and controls were ask...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1136/bmj.300.6719.227
更新日期:1990-01-27 00:00:00
abstract:OBJECTIVE:To determine whether use of intermediate acting neuromuscular blocking agents during general anesthesia increases the incidence of postoperative respiratory complications. DESIGN:Prospective, propensity score matched cohort study. SETTING:General teaching hospital in Boston, Massachusetts, United States, 20...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e6329
更新日期:2012-10-15 00:00:00
abstract::Objective To characterize the prospective controlled clinical studies for all novel drugs that were initially approved by the Food and Drug Administration on the basis of limited evidence.Design Systematic review.Data sources Drugs@FDA database and PubMed.Study inclusion All prospective controlled clinical studies pub...
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pub_type: 杂志文章,评审
doi:10.1136/bmj.j1680
更新日期:2017-05-03 00:00:00
abstract:OBJECTIVE:To quantify the impact of citalopram and other selective serotonin reuptake inhibitors on corrected QT interval (QTc), a marker of risk for ventricular arrhythmia, in a large and diverse clinical population. DESIGN:A cross sectional study using electrocardiographic, prescribing, and clinical data from electr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f288
更新日期:2013-01-29 00:00:00
abstract:OBJECTIVE:To map and assess prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Systematic review. DATA SOURCES:PubMed until November 2018 and hand searched references from eligible articles. ELIGIBILITY CRITERIA FOR STUDY SELECTION:Studies developing, valid...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.l5358
更新日期:2019-10-04 00:00:00
abstract:OBJECTIVES:To calculate socioeconomic and health status measures for the primary care groups in London and to examine the association between these measures and hospital admission rates. DESIGN:Cross sectional study. SETTING:66 primary care groups in London, total list size 8.0 million people. MAIN OUTCOME MEASURES:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7268.1057
更新日期:2000-10-28 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of interventions designed to improve outcomes in patients with multimorbidity in primary care and community settings. DESIGN:Systematic review. DATA SOURCES:Medline, Embase, CINAHL, CAB Health, Cochrane central register of controlled trials, the database of abstracts of review...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.e5205
更新日期:2012-09-03 00:00:00
abstract:OBJECTIVE:To explore genetic and environmental contributions to the influence of parental social class and region of upbringing on adult human fatness. DESIGN:Survey of sample of adults who had been adopted in childhood to relate their body mass index to sociodemographic variables in a series of multiple linear regres...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6740.1615
更新日期:1990-06-23 00:00:00
abstract:OBJECTIVE:To assess whether a late evening meal would improve nitrogen balance in patients with cirrhosis of the liver. DESIGN:Randomised crossover study of meal schedules comparing three meals a day with four or six meals a day, the four and six meal schedules both including a late evening meal (2300). SETTING:Metab...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.299.6709.1202
更新日期:1989-11-11 00:00:00
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pub_type: 杂志文章,meta分析
doi:10.1136/bmj.l6202
更新日期:2019-12-18 00:00:00
abstract:OBJECTIVE:To study prevalence of Turner's syndrome in Denmark and to assess validity of prenatal diagnosis. DESIGN:Study of data on prenatal and postnatal Turner's syndrome in Danish Cytogenetic Central Register. SUBJECTS:All registered Turner's syndrome karyotypes (100 prenatal cases and 215 postnatal cases) during ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7022.16
更新日期:1996-01-06 00:00:00
abstract:OBJECTIVES:To compare patients' preference for transdermal fentanyl or sustained release oral morphine, their level of pain control, and their quality of life after treatment. DESIGN:Randomised, multicentre, international, open label, crossover trial. SETTING:35 centres in Belgium, Canada, Denmark, Finland, the Unite...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.322.7295.1154
更新日期:2001-05-12 00:00:00
abstract:OBJECTIVES:To identify factors that differentiate between effective and ineffective computerised clinical decision support systems in terms of improvements in the process of care or in patient outcomes. DESIGN:Meta-regression analysis of randomised controlled trials. DATA SOURCES:A database of features and effects of...
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pub_type: 杂志文章,meta分析
doi:10.1136/bmj.f657
更新日期:2013-02-14 00:00:00
abstract:OBJECTIVE:To determine the efficacy and safety of the anticoagulant fondaparinux in older acute medical inpatients at moderate to high risk of venous thromboembolism. DESIGN:Double blind randomised placebo controlled trial. SETTING:35 centres in eight countries. PARTICIPANTS:849 medical patients aged 60 or more admi...
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38733.466748.7C
更新日期:2006-02-11 00:00:00
abstract:PROBLEM:Despite widespread acceptance of the Ottawa ankle rules for assessment of acute ankle injuries, their application varies considerably. DESIGN:Before and after study. BACKGROUND AND SETTING:Emergency departments of a tertiary teaching hospital and a community hospital in Australia. KEY MEASURES FOR IMPROVEMEN...
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b3056
更新日期:2009-08-12 00:00:00
abstract::An investigation was conducted to determine the vehicle of infection of an outbreak of food poisoning in a large metropolitan building early in 1988. A questionnaire was distributed to 700 people who had eaten in the building during the week of the outbreak, and attack rates for specific food were calculated. Food and...
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pub_type: 杂志文章
doi:10.1136/bmj.298.6666.99
更新日期:1989-01-14 00:00:00
abstract:OBJECTIVE:To assess the relation between pretraumatic and trauma related headache in patients suffering from whiplash. DESIGN:Follow up study of patients examined a mean (SD) of 7.4 (4.2) days after trauma and again at three and six months. SETTING:Patients referred from primary care. SUBJECTS:117 patients (mean age...
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pub_type: 杂志文章
doi:10.1136/bmj.307.6905.652
更新日期:1993-09-11 00:00:00
abstract:OBJECTIVE:To investigate whether an important football match increases stress to such an extent that it triggers acute myocardial infarction and stroke. DESIGN:Longitudinal study of mortality around 22 June 1996 (the day the Dutch football team was eliminated from the European football championship). Mortality on 22 J...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7276.1552
更新日期:2000-12-23 00:00:00
abstract:OBJECTIVES:To investigate the perspectives of patients with asthma on the use of an action plan and the implementation of this plan during an asthma attack that culminated in a visit to an emergency department. DESIGN:Qualitative study. SETTING:Tertiary teaching hospital, suburban hospital, and rural hospital. PARTI...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.324.7344.1003
更新日期:2002-04-27 00:00:00