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Erschienen in:
12.01.2021 | Original Article
Colorectal Cancer Screening Guidelines Are Primarily Based on Low–Moderate-Quality Evidence
Erschienen in: Digestive Diseases and Sciences | Ausgabe 12/2021
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Background
Owning to colorectal cancer’s (CRC) high mortality, multiple societies developed screening guidelines.
Aims
We aimed to assess the overall quality of CRC screening guidelines.
Methods
A systematic search was performed to review CRC screening guidelines for conflicts of interest (COI), recommendation quality and strength, external document review, use of patient representative, and recommendation age—as per Institute of Medicine (IOM) standards. In addition, recommendations were compared between guidelines/societies. Statistical analysis was conducted using R.
Results
Twelve manuscripts were included in final analysis. Not all guidelines reported on COI, provided a grading method, underwent external review, or included patient representation. 14.5%, 34.2%, and 51.3% of recommendations were based on high-, moderate-, and low-quality evidence, respectively. 27.8%, 54.6%, and 17.5% of recommendations were strong, weak/conditional, and did not provide a strength, respectively. The proportion of high-quality evidence and strong recommendations did not significantly differ across societies, nor were significant associations between publication year and evidence quality seen (P = 0.4).
Conclusions
While the majority of the CRC guidelines contain aspects of the standards set forth by the IOM, there is an overall lack of adherence. As over 85% of recommendations are based on low–moderate quality evidence, further studies on CRC screening are warranted to improve the overall quality of evidence.