Tom Nolan’s research reviews—20 October 2022

The first RCT on colonoscopy screeningUntil now, recommendations supporting colonoscopy for colorectal cancer screening have been based on cohort studies. Now we have a randomised control trial—the results of which have caused quite a stir. The participants, aged 55-64 years, who received an invitation for colorectal cancer screening had an 18% lower 10 year risk of developing colorectal cancer compared with controls, but there was no significant effect on the risk of death from colorectal cancer. The per-protocol analysis is more optimistic, but controversial due to the risk of bias: for the 42% of people invited for colonoscopy who actually had one, the risk of colorectal cancer reduced from 1.22% to 0.84% over 10 years (a 31% reduction), and their risk of death from colorectal cancer reduced from 0.3% to 0.15% (a 50% reduction).N Engl J Med doi:10.1056/NEJMoa2208375Sigmoidoscopy gets a look inTo remind us that there have been several randomised…
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