MCC 2011 - Slide 18

Screening for colorectal cancer Lars Påhlman Dept Surgery, Colorectal unit University Hospital, Uppsala, Sweden

‘ The presumptive identification of unrecognised disease or defect by application of tests, examinations or other procedures that can be applied rapidly’ U.S. Commission on Chronic Illness

Ideal screening situation ,[object Object],[object Object],[object Object]

The common screening situation ,[object Object],[object Object],[object Object]

Colorectal cancer - Screening ,[object Object],[object Object]

Colorectal cancer - Screening ,[object Object],[object Object],[object Object]

Colorectal cancer - Screening ,[object Object],[object Object],[object Object],[object Object]

A B Detectable by screening Clinically detectable Length biased sampling Time

Length time bias ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Time A B C D The disease starts Detectable Clinically presented Death Lead time Lead time bias

Lead time bias ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Prevention Cure Early diagnosis

Colorectal cancer ,[object Object],[object Object],[object Object]

Colorectal cancer ,[object Object],[object Object],[object Object],[object Object]

Colorectal cancer - Screening ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Colorectal cancer - Screening ,[object Object],[object Object],[object Object],[object Object],[object Object]

Colorectal cancer - Screening ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Screening för kolorektal cancer ,[object Object],[object Object],[object Object]

Screening för kolorektal cancer ,[object Object],[object Object],[object Object],[object Object]

FOBT Screening - mortality from CRC Heitson et an. Cochrane Database of Systematic Reviews 2007

FOBT screening - total mortality Heitson et an. Cochrane Database of Systematic Reviews 2007

Flex-sig screening - CRC mortality Atkin et al, Lancet 2010

MCC 2011 - Slide 18

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