Invited Lecture(JSGCS)
Thu. November 5th   11:20 - 12:00   Room 7: Portopia Hotel South Wing Ohwada C
Invited Lecture19
 IARC Handbooks of cancer prevention Volume 17: Colorectal cancer screening
Beatrice Lauby-Secretan
International Agency for Research on Cancer
The IARC Handbooks of Cancer prevention conduct evidence-based expert evaluations on the cancer preventive effects of agents or interventions. Colorectal cancer is the third most common cancer in men and the second most common in women. In November 2017, 23 experts from 15 countries met at the International Agency for Research on Cancer in Lyon, France to evaluate different methods of colorectal cancer screening for CRC, by assessing the benefits in reducing mortality and incidence, and the net benefit-harm ratio, taking into account medical and psychological adverse effects. Evaluations were conducted for stool-based blood tests [guaiac faecal occult blood test (gFOBT) and immunochemical fecal test (FIT)], endoscopic techniques (colonoscopy and sigmoidoscopy) and computed tomographic (CT) colonography, an imaging method based on scanning technology. The published evidence from randomized controlled trials, observational studies and modelling studies was critically reviewed and evaluated by consensus. The Handbook also covered other relevant topics, including worldwide availability of colorectal cancer screening, participation to screening, emerging techniques and screening in high-risk groups.
After review of the available evidence, the Working Group concluded that there is sufficient evidence that the established screening strategies (i.e.gFOBT, FIT, sigmoidoscopy and endoscopy) decrease the risk of colorectal cancer mortality; the balance of benefit to harm is positive with all techniques, although for colonoscopy the harms are more substantial than for other methods. Evidence for a reduction in colorectal cancer incidence and/or mortality following screening with CT colonography is limited due to the lack of adequate studies.
Network analyses provide indirect comparison of the effectiveness of the different methods, by using data from studies with screening compared to no screening. However, the evidence was considered to be insufficient to draw a conclusion.
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