Quantification of harms in cancer screening trials: literature review
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/23286 |
Resumo: | Objectives To assess how often harm is quantified in randomised trials of cancer screening. Design Two authors independently extracted data on harms from randomised cancer screening trials. Binary outcomes were described as proportions and continuous outcomes with medians and interquartile ranges. Data sources For cancer screening previously assessed in a Cochrane review, we identified trials from their reference lists and updated the search in CENTRAL. For cancer screening not assessed in a Cochrane review, we searched CENTRAL, Medline, and Embase. Eligibility criteria for selecting studies Randomised trials that assessed the efficacy of cancer screening for reducing incidence of cancer, cancer specific mortality, and/or all cause mortality. Data extraction Two reviewers independently assessed articles for eligibility. Two reviewers, who were blinded to the identity of the study's authors, assessed whether absolute numbers or incidence rates of outcomes related to harm were provided separately for the screening and control groups. The outcomes were false positive findings, overdiagnosis, negative psychosocial consequences, somatic complications, invasive follow-up procedures, all cause mortality, and withdrawals because of adverse events. Results Out of 4590 articles assessed, 198 (57 trials, 10 screening technologies) matched the inclusion criteria. False positive findings were quantified in two of 57 trials (4\%, 95\% confidence interval 0\% to 12\%), overdiagnosis in four (7\%, 2\% to 18\%), negative psychosocial consequences in five (9\%, 3\% to 20\%), somatic complications in 11 (19\%, 10\% to 32\%), use of invasive follow-up procedures in 27 (47\%, 34\% to 61\%), all cause mortality in 34 (60\%, 46\% to 72\%), and withdrawals because of adverse effects in one trial (2\%, 0\% to 11\%). The median percentage of space in the results section that reported harms was 12\% (interquartile range 2-19\%). Conclusions Cancer screening trials seldom quantify the harms of screening. Of the 57 cancer screening trials examined, the most important harms of screening-overdiagnosis and false positive findings-were quantified in only 7\% and 4\%, respectively. |
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Quantification of harms in cancer screening trials: literature reviewUPDATED GUIDELINESRANDOMIZED CONTROLLED-TRIALSPROSTATE-CANCERLUNG-CANCERSERVICES-TASK-FORCEAGE 40COLORECTAL-CANCERBREAST-CANCERFOLLOW-UPCLINICAL-TRIALSRANDOMIZED CONTROLLED-TRIALSSERVICES-TASK-FORCEFOLLOW-UPBREAST-CANCERLUNG-CANCERPROSTATE-CANCERUPDATED GUIDELINESCOLORECTAL-CANCERCLINICAL-TRIALSAGE 40SDG 3 - Good Health and Well-beingObjectives To assess how often harm is quantified in randomised trials of cancer screening. Design Two authors independently extracted data on harms from randomised cancer screening trials. Binary outcomes were described as proportions and continuous outcomes with medians and interquartile ranges. Data sources For cancer screening previously assessed in a Cochrane review, we identified trials from their reference lists and updated the search in CENTRAL. For cancer screening not assessed in a Cochrane review, we searched CENTRAL, Medline, and Embase. Eligibility criteria for selecting studies Randomised trials that assessed the efficacy of cancer screening for reducing incidence of cancer, cancer specific mortality, and/or all cause mortality. Data extraction Two reviewers independently assessed articles for eligibility. Two reviewers, who were blinded to the identity of the study's authors, assessed whether absolute numbers or incidence rates of outcomes related to harm were provided separately for the screening and control groups. The outcomes were false positive findings, overdiagnosis, negative psychosocial consequences, somatic complications, invasive follow-up procedures, all cause mortality, and withdrawals because of adverse events. Results Out of 4590 articles assessed, 198 (57 trials, 10 screening technologies) matched the inclusion criteria. False positive findings were quantified in two of 57 trials (4\%, 95\% confidence interval 0\% to 12\%), overdiagnosis in four (7\%, 2\% to 18\%), negative psychosocial consequences in five (9\%, 3\% to 20\%), somatic complications in 11 (19\%, 10\% to 32\%), use of invasive follow-up procedures in 27 (47\%, 34\% to 61\%), all cause mortality in 34 (60\%, 46\% to 72\%), and withdrawals because of adverse effects in one trial (2\%, 0\% to 11\%). The median percentage of space in the results section that reported harms was 12\% (interquartile range 2-19\%). Conclusions Cancer screening trials seldom quantify the harms of screening. Of the 57 cancer screening trials examined, the most important harms of screening-overdiagnosis and false positive findings-were quantified in only 7\% and 4\%, respectively.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNHeleno, BrunoThomsen, Maria FRodrigues, David SJorgensen, Karsten JBrodersen, John2017-09-15T22:00:53Z2013-09-162013-09-16T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article9application/pdfhttp://hdl.handle.net/10362/23286eng0959-8138PURE: 298042https://doi.org/10.1136/bmj.f5334info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:11:32Zoai:run.unl.pt:10362/23286Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:27:44.766659Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Quantification of harms in cancer screening trials: literature review |
title |
Quantification of harms in cancer screening trials: literature review |
spellingShingle |
Quantification of harms in cancer screening trials: literature review Heleno, Bruno UPDATED GUIDELINES RANDOMIZED CONTROLLED-TRIALS PROSTATE-CANCER LUNG-CANCER SERVICES-TASK-FORCE AGE 40 COLORECTAL-CANCER BREAST-CANCER FOLLOW-UP CLINICAL-TRIALS RANDOMIZED CONTROLLED-TRIALS SERVICES-TASK-FORCE FOLLOW-UP BREAST-CANCER LUNG-CANCER PROSTATE-CANCER UPDATED GUIDELINES COLORECTAL-CANCER CLINICAL-TRIALS AGE 40 SDG 3 - Good Health and Well-being |
title_short |
Quantification of harms in cancer screening trials: literature review |
title_full |
Quantification of harms in cancer screening trials: literature review |
title_fullStr |
Quantification of harms in cancer screening trials: literature review |
title_full_unstemmed |
Quantification of harms in cancer screening trials: literature review |
title_sort |
Quantification of harms in cancer screening trials: literature review |
author |
Heleno, Bruno |
author_facet |
Heleno, Bruno Thomsen, Maria F Rodrigues, David S Jorgensen, Karsten J Brodersen, John |
author_role |
author |
author2 |
Thomsen, Maria F Rodrigues, David S Jorgensen, Karsten J Brodersen, John |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
dc.contributor.author.fl_str_mv |
Heleno, Bruno Thomsen, Maria F Rodrigues, David S Jorgensen, Karsten J Brodersen, John |
dc.subject.por.fl_str_mv |
UPDATED GUIDELINES RANDOMIZED CONTROLLED-TRIALS PROSTATE-CANCER LUNG-CANCER SERVICES-TASK-FORCE AGE 40 COLORECTAL-CANCER BREAST-CANCER FOLLOW-UP CLINICAL-TRIALS RANDOMIZED CONTROLLED-TRIALS SERVICES-TASK-FORCE FOLLOW-UP BREAST-CANCER LUNG-CANCER PROSTATE-CANCER UPDATED GUIDELINES COLORECTAL-CANCER CLINICAL-TRIALS AGE 40 SDG 3 - Good Health and Well-being |
topic |
UPDATED GUIDELINES RANDOMIZED CONTROLLED-TRIALS PROSTATE-CANCER LUNG-CANCER SERVICES-TASK-FORCE AGE 40 COLORECTAL-CANCER BREAST-CANCER FOLLOW-UP CLINICAL-TRIALS RANDOMIZED CONTROLLED-TRIALS SERVICES-TASK-FORCE FOLLOW-UP BREAST-CANCER LUNG-CANCER PROSTATE-CANCER UPDATED GUIDELINES COLORECTAL-CANCER CLINICAL-TRIALS AGE 40 SDG 3 - Good Health and Well-being |
description |
Objectives To assess how often harm is quantified in randomised trials of cancer screening. Design Two authors independently extracted data on harms from randomised cancer screening trials. Binary outcomes were described as proportions and continuous outcomes with medians and interquartile ranges. Data sources For cancer screening previously assessed in a Cochrane review, we identified trials from their reference lists and updated the search in CENTRAL. For cancer screening not assessed in a Cochrane review, we searched CENTRAL, Medline, and Embase. Eligibility criteria for selecting studies Randomised trials that assessed the efficacy of cancer screening for reducing incidence of cancer, cancer specific mortality, and/or all cause mortality. Data extraction Two reviewers independently assessed articles for eligibility. Two reviewers, who were blinded to the identity of the study's authors, assessed whether absolute numbers or incidence rates of outcomes related to harm were provided separately for the screening and control groups. The outcomes were false positive findings, overdiagnosis, negative psychosocial consequences, somatic complications, invasive follow-up procedures, all cause mortality, and withdrawals because of adverse events. Results Out of 4590 articles assessed, 198 (57 trials, 10 screening technologies) matched the inclusion criteria. False positive findings were quantified in two of 57 trials (4\%, 95\% confidence interval 0\% to 12\%), overdiagnosis in four (7\%, 2\% to 18\%), negative psychosocial consequences in five (9\%, 3\% to 20\%), somatic complications in 11 (19\%, 10\% to 32\%), use of invasive follow-up procedures in 27 (47\%, 34\% to 61\%), all cause mortality in 34 (60\%, 46\% to 72\%), and withdrawals because of adverse effects in one trial (2\%, 0\% to 11\%). The median percentage of space in the results section that reported harms was 12\% (interquartile range 2-19\%). Conclusions Cancer screening trials seldom quantify the harms of screening. Of the 57 cancer screening trials examined, the most important harms of screening-overdiagnosis and false positive findings-were quantified in only 7\% and 4\%, respectively. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-09-16 2013-09-16T00:00:00Z 2017-09-15T22:00:53Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/23286 |
url |
http://hdl.handle.net/10362/23286 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
0959-8138 PURE: 298042 https://doi.org/10.1136/bmj.f5334 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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9 application/pdf |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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