4 september 2023: Bron: JAMA Intern Med. Published online August 28, 2023

Kankerscreening, zoals mammografie voor borstkanker; colonoscopie van de darmen, sigmoïdoscopie of fecaal occult bloedonderzoek (FOBT) voor darmkanker; computertomografiescreening op longkanker bij rokers en voormalige rokers; en prostaatspecifieke antigeentesten voor prostaatkanker verlengt mogelijk niet daadwerkelijk de levensduur. Alleen een sigmoïdoscopie bij darmkanker verlengde de mediane levensduur met 110 dagen. 

Dat alles blijkt uit een meta-analyse van Michael Bretthauer, M.D., Ph.D., en collega's van de Universiteit van Oslo in Noorwegen. Zij voerden een review en meta-analyse uit van 18 klinische onderzoeken met meer dan negen jaar follow-up, waarin sterfte door alle oorzaken en geschatte levenswinsten van zes jaar werden gerapporteerd tussen veelgebruikte kankerscreeningstests versus geen screening.

Op basis van de onderzoeksgegevens van meer dan 2,1 miljoen proefdeelnemers ontdekten de onderzoekers dat de enige screeningstest met een significante levenslange winst sigmoïdoscopie (110 dagen) was. Er waren geen significante verschillen in levensduur na mammografie en FOBT-screening elk jaar of om de twee jaar.
Voor screening op prostaatkanker en longkanker waren de schattingen van de langere levensduur onzeker. Schattingen van de langere levensduur voor colonoscopie voor darmkanker (37 dagen) waren op basis van de gegevens ook onzeker.

Het volledige studierapport is tegen betaling in te zien. Hier het abstract van de studie:

related articles icon 
Related
Articles
 
Key Points

Question  Cancer screening tests are promoted to save lives, but how much is life extended due to commonly used cancer screening tests?

Findings  In this systematic review and meta-analysis of 18 long-term randomized clinical trials involving 2.1 million individuals, colorectal cancer screening with sigmoidoscopy prolonged lifetime by 110 days, while fecal testing and mammography screening did not prolong life. An extension of 37 days was noted for prostate cancer screening with prostate-specific antigen testing and 107 days with lung cancer screening using computed tomography, but estimates are uncertain.

Meaning  The findings of this meta-analysis suggest that colorectal cancer screening with sigmoidoscopy may extend life by approximately 3 months; lifetime gain for other screening tests appears to be unlikely or uncertain.

Abstract

Importance  Cancer screening tests are promoted to save life by increasing longevity, but it is unknown whether people will live longer with commonly used cancer screening tests.

Objective  To estimate lifetime gained with cancer screening.

Data Sources  A systematic review and meta-analysis was conducted of randomized clinical trials with more than 9 years of follow-up reporting all-cause mortality and estimated lifetime gained for 6 commonly used cancer screening tests, comparing screening with no screening. The analysis included the general population. MEDLINE and the Cochrane library databases were searched, and the last search was performed October 12, 2022.

Study Selection  Mammography screening for breast cancer; colonoscopy, sigmoidoscopy, or fecal occult blood testing (FOBT) for colorectal cancer; computed tomography screening for lung cancer in smokers and former smokers; or prostate-specific antigen testing for prostate cancer.

Data Extraction and Synthesis  Searches and selection criteria followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Data were independently extracted by a single observer, and pooled analysis of clinical trials was used for analyses.

Main Outcomes and Measures  Life-years gained by screening was calculated as the difference in observed lifetime in the screening vs the no screening groups and computed absolute lifetime gained in days with 95% CIs for each screening test from meta-analyses or single randomized clinical trials.

Results  In total, 2 111 958 individuals enrolled in randomized clinical trials comparing screening with no screening using 6 different tests were eligible. Median follow-up was 10 years for computed tomography, prostate-specific antigen testing, and colonoscopy; 13 years for mammography; and 15 years for sigmoidoscopy and FOBT. The only screening test with a significant lifetime gain was sigmoidoscopy (110 days; 95% CI, 0-274 days). There was no significant difference following mammography (0 days: 95% CI, −190 to 237 days), prostate cancer screening (37 days; 95% CI, −37 to 73 days), colonoscopy (37 days; 95% CI, −146 to 146 days), FOBT screening every year or every other year (0 days; 95% CI, −70.7 to 70.7 days), and lung cancer screening (107 days; 95% CI, −286 days to 430 days).

Conclusions and Relevance  The findings of this meta-analysis suggest that current evidence does not substantiate the claim that common cancer screening tests save lives by extending lifetime, except possibly for colorectal cancer screening with sigmoidoscopy.

 





Plaats een reactie ...

Reageer op "Screeningtesten voor opsporen van kanker zoals voor borstkanker, longkanker, darmkanker en prostaatkanker lijken geen invloed te hebben op uiteindelijke levensduur"


Gerelateerde artikelen
 

Gerelateerde artikelen

Algemeen: Voeding en voedingstoffen >> Alzheimer - dementie is via >> Antibiotica speelt mogelijk >> Asbest lijkt ook kanker in >> Aspirine ter voorkoming van >> Bacterien in de mond - Commensale >> Diakonessenhuis Utrecht biedt >> DIM - diindolylmethane voorkomt >> Bloedbiomarker waarden van >> Bloedtest die methyl meet >>