Imperial College London
Portrait Picture

Professor Amanda Cross

Faculty of Medicine, School of Public Health

Professor of Cancer Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 3338amanda.cross

 
 
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Assistant

 

Mr Will Kay +44 (0)20 7594 3350

 
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Location

 

Room 1089Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Atkin:2017:10.1016/S0140-6736(17)30396-3,
author = {Atkin, WS and Wooldrage, K and Parkin, DM and Kralj-Hans, I and MacRae, E and Shah, U and Duffy, S and Cross, AJ},
doi = {10.1016/S0140-6736(17)30396-3},
journal = {The Lancet},
pages = {1299--1311},
title = {Long term effects of once-only flexible sigmoidoscopy screening after 17 years of follow-up: the UK Flexible Sigmoidoscopy Screening randomised controlled trail},
url = {http://dx.doi.org/10.1016/S0140-6736(17)30396-3},
volume = {389},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: This multicentre randomised trial is examining the effect of single flexible sigmoidoscopy (FS) screening on colorectal cancer (CRC) incidence and mortality. Previous analyses of this and other trials have only reported follow-up after FS for a maximum of 12 years. The objective of this analysis was to examine the long-term effects of FS after 17 years of follow-up.Methods: Between 1994 and 1999, 170,432 eligible men and women, who had indicated on a previous questionnaire that they would probably attend for screening if invited, were randomised to an intervention group (offered FS screening) or a control group (not contacted) in a 1:2 ratio. Randomisation was performed centrally in blocks of 12, and stratified by trial centre, general practice and household type. The primary outcomes were incidence and mortality of CRC. Hazard ratios (HR) and 95% confidence intervals (CI) for CRC incidence and mortality were estimated for intention-to-treat and per-protocol analyses. The trial is registered, number ISRCTN28352761.Findings: This analysis included 170,034 people (57,098 in the intervention and 112,936 in the control group). During screening and a median of 17.1 years’ follow-up, CRC was diagnosed in 1,230 individuals in the intervention and 3,253 in the control group, and 353 vs. 996 respectively died from CRC. In intention-to-treat analyses, CRC incidence was reduced by 26% (HR 0.74, 95% CI 0.70-0.80) and CRC mortality by 30% (HR 0.70, 95% CI 0.62-0.79). In per-protocol analyses, adjusted for non-compliance, CRC incidence and mortality were 35% (HR 0.65, 95% CI 0.59-0.71) and 41% (HR 0.59, 95% CI 0.49-0.70) lower in attenders.  Interpretation: A single FS continues to provide substantial protection from CRC diagnosis and death, with protection lasting at least 17 years.
AU  - Atkin,WS
AU  - Wooldrage,K
AU  - Parkin,DM
AU  - Kralj-Hans,I
AU  - MacRae,E
AU  - Shah,U
AU  - Duffy,S
AU  - Cross,AJ
DO  - 10.1016/S0140-6736(17)30396-3
EP  - 1311
PY  - 2017///
SN  - 0140-6736
SP  - 1299
TI  - Long term effects of once-only flexible sigmoidoscopy screening after 17 years of follow-up: the UK Flexible Sigmoidoscopy Screening randomised controlled trail
T2  - The Lancet
UR  - http://dx.doi.org/10.1016/S0140-6736(17)30396-3
UR  - http://hdl.handle.net/10044/1/44343
VL  - 389
ER  -
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