What do Cochrane systematic reviews say about the clinical effectiveness of screening and diagnostic tests for cancer?

What do Cochrane systematic reviews say about the clinical effectiveness of screening and diagnostic tests for cancer?

Author Pereira Bueno, Andre Tito Autor UNIFESP Google Scholar
Capelasso, Vladimir Lisboa Autor UNIFESP Google Scholar
Pacheco, Rafael Leite Autor UNIFESP Google Scholar
Cruz Latorraca, Carolina de Oliveira Autor UNIFESP Google Scholar
de Castria, Tiago Biachi Google Scholar
Pachito, Daniela Vianna Autor UNIFESP Google Scholar
Riera, Rachel Autor UNIFESP Google Scholar
Abstract CONTEXT AND OBJECTIVE: The purpose of screening tests for cancer is to detect it at an early stage in order to increase the chances of treatment. However, their unrestrained use may lead to unnecessary examinations, overdiagnosis and higher costs. It is thus necessary to evaluate their clinical effects in terms of benefits and harm. DESIGN AND SETTING: Review of Cochrane systematic reviews, carried out in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de Sao Paulo. METHODS: Cochrane reviews on the clinical effectiveness of cancer screening procedures were included. Study titles and abstracts were independently assessed by two authors. Conflicts were resolved by another two authors. Findings were summarized and discussed. RESULTS: Seventeen reviews were selected: fifteen on screening for specific cancers (bladder, breast, colorectal, hepatic, lung, nasopharyngeal, esophageal, oral, prostate, testicular and uterine) and two others on cancer in general. The quality of evidence of the findings varied among the reviews. Only two reviews resulted in high-quality evidence: screening using low-dose computed tomography scans for high-risk individuals seems to reduce lung cancer mortality

and screening using flexible sigmoidoscopy and fecal occult blood tests seems to reduce colorectal cancer mortality. CONCLUSION: The evidence found through Cochrane reviews did not support most of the commonly used screening tests for cancer. It is recommended that patients should be informed of the possibilities of false positives and false negatives before they undergo the tests. Further studies to fully assess the effectiveness of cancer screening tests and adverse outcomes are required.
Keywords Diagnosis
Early detection of cancer
Treatment outcome
Review [publication type]
Evidence-based practice
xmlui.dri2xhtml.METS-1.0.item-coverage Sao Paulo
Language English
Date 2017
Published in Sao Paulo Medical Journal. Sao Paulo, v. 135, n. 4, p. 401-410, 2017.
ISSN 1516-3180 (Sherpa/Romeo, impact factor)
Publisher Associacao Paulista Medicina
Extent 401-410
Origin http://dx.doi.org/10.1590/1516-3180.2017.0171110717
Access rights ACESSO ABERTO
Type Article
Web of Science ID WOS:000407814900013
SciELO ID S1516-31802017000400401 (statistics in SciELO)
URI https://repositorio.unifesp.br/handle/11600/53537

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