Validität der Empfehlungen zur Prävention von Darmkrebs

Abstract

The validity of recommendations by nine national and international organisations regarding colorectal cancer prevention has been examined. The analysis of primary prevention included lifestyle factors. The validity was assessed by amount of peer reviewed references. As a result risk factors that are most likely to have an impact on the devolpment of colorectal cancer are: lack of physical activity, overweight, and regular intake of red and processed meat. The analysis of secondary prevention included information on the age of people screened and seven screening methods. The only test recommended by all nine organisations is an annual or biennial occult blood test. Of the 33 studies providing evidence for colorectal cancer screening, only 17 used reduction of mortality as an endpoint. These studies and a Cochrane Review of studies on the gFOBT were analysed according to our test procedure. On average the studies met two out of nine criteria for validity, five criteria were fulfilled to some extent, and two criteria were not met at all. Therefore, these recommendations for colon cancer screening are based on data of low validity. This might explain the substantial differences between the various recommendations. The implementation of an independent register that allows us to quantitate all the advantages and disadvantages of colon cancer screening under daily routine conditions should be discussed.