J Cancer 2020; 11(20):5953-5970. doi:10.7150/jca.46661

Research Paper

Colonoscopic screening is associated with reduced Colorectal Cancer incidence and mortality: a systematic review and meta-analysis

Jiaxin Zhang1,2*, Guang Chen1,2*, Zhiguo Li1,2, Peng Zhang1,2, Xiaoke Li1,2, Da'nan Gan1,2, Xu Cao1,2, Hongbo Du1,2, Jiaying Zhang3, Ludan Zhang1,2, Yong'an Ye1,2✉

1. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
2. Institute of Liver Diseases, Beijing University of Chinese Medicine.
3. Ministry of Education Key Laboratory of Bioinformatics, Tsinghua-Peking Center for Life Sciences, School of Life Sciences, Tsinghua University, Beijing 100084, China.
*These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Zhang J, Chen G, Li Z, Zhang P, Li X, Gan D, Cao X, Du H, Zhang J, Zhang L, Ye Y. Colonoscopic screening is associated with reduced Colorectal Cancer incidence and mortality: a systematic review and meta-analysis. J Cancer 2020; 11(20):5953-5970. doi:10.7150/jca.46661. Available from https://www.jcancer.org/v11p5953.htm

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It is the great priority to detect colorectal cancer (CRC) as early as possible, finally to reduce the incidence and mortality of CRC. However, although colonoscopy is recommended in many consensuses, yet no one systematic review is conducted to figure out how colonoscopy could change the incidence and mortality. In our study, we conducted a comprehensive meta-analysis to evaluate the association between colonoscopy screening and the incidence or mortality of CRC. PubMed, EMBASE, and PMC database were systematically searched from their inception to June 2020. A total of 13 cohort and 16 case-control studies comprising 4,713,778 individuals were obtained in this review. Our results showed that colonoscopy was associated with a 52% RR reduction in incidence of CRC (RR: 0.48, 95% CI: 0.46-0.49) and 62% RR reduction in mortality of CRC (RR: 0.38, 95% CI: 0.36-0.40). Subgroup analysis of different interventions, study design, country, sample size, age or sex showed that the incidence and mortality reduction remained consistent, and colonoscopy screening had the same effect on people below and above 50. Our study indicated that colonoscopy could significantly reduce the incidence and mortality of CRC.

Keywords: colorectal cancer, colonoscopy, incidence and mortality, meta-analysis