Email Alert | RSS

Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (3): 548-555. doi: 10.19723/j.issn.1671-167X.2019.03.026

Previous Articles     Next Articles

Quality assessment of global guidelines on colorectal cancer screening

Le GAO1,Shu-qing YU1,Ji-chun YANG1,Jun-ling MA2,Si-yan ZHAN1,3,Feng SUN1△()   

  1. 1. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
    2. Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China;
    3. Center of Evidence-based Medicine and Clinical Research, Peking University, Beijing 100191, China
  • Received:2019-03-18 Online:2019-06-18 Published:2019-06-26
  • Supported by:
    Supported by the National Natural Science Foundation of China(71673003)

RICH HTML

   

PDF (PC)

Abstract: Objective: To systematically review and assess the quality of guidelines on colorectal cancer screening worldwide to provide guidance for the development of high-quality colorectal cancer screening guidelines in mainland China.Methods: CNKI, WanFang Data, VIP, SinoMed, PubMed, Embase, and Web of Science were systematically searched to identify guidelines on colorectal cancer screening from inception to Jun. 20 th, 2018, and so were some websites and major search engines about the deve-lopment of the guidelines from the existing literature (search date: Aug. 3 rd, 2018). Two experienced reviewers independently examined these abstracts and then extracted information, and the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) were used to evaluate the methodological quality of these guidelines by four well trained reviewers. Results: In this study, 46 guidelines published from 1994 to 2018 were finally included in our analysis from 10 countries and 5 regions, among which 5 were from mainland China. The quality of these guidelines was relatively high in domain 1 (scope and purpose) and domain 4 (clarity of presentation), and medium in domain 2 (stakeholder involvement). While in the other three domains (domain 3: rigour of development; domain 5: applicability; domain 6: editorial independence), the results were quite different among these guidelines. The quality of evidence-based guidelines (defined by the criteria based on World Health Organization guideline development handbook) was generally higher than that of the common guidelines. Existing guidelines from mainland China were not evidence-based guidelines, which were of low quality.Conclusion: The colorectal cancer screening guidelines all over the world are generally large in number, low in quality, different in statements, and so are the guidelines in China. There are no evidence-based guidelines in mainland China, which cannot provide effective guidance for colorectal cancer screening, so we need to pay more attention to the establishment of guidelines with high quality and high credibility for colorectal cancer screening as well as for cancer screening based on the national condition, in order to provide reasonable guidance for practice in public health and improve the health conditions in our society.

Key words: Colorectal cancer, Screening, Guideline, Systematic review, AGREE Ⅱ

CLC Number: 

  • R181.2

Figure 1

Flow chart of studies considered for inclusion E, guidelines in English; C, guidelines in Chinese. CNKI, China national knowledge infrastructure; SinoMed, Chinese biomedical literature database; VIP, China science and technology journal database."

Table 1

Basic information of included studies"

No. Name of guideline Publishing organization Country/
region		 Year Update Evidence-based
guideline
1 Cascade colorectal cancer screening guidelines a global conceptual model World Gastroenterology Organization (WGO) Global 2011 NO

Table 2

AGREE Ⅱ results of included guidelines"

No. Domain scores/% Overall quality Recommendation ICC
1 2 3 4 5 6 Yes Yes, with modifications No
1 61 25 16 71 14 73 3.00 0 1 3 0.95
2 56 44 2 57 1 0 2.25 0 0 4 0.96
3 75 68 58 85 21 71 4.75 3 1 0 0.97
4 83 74 65 89 58 73 5.50 4 0 0 0.95
5 61 24 7 76 11 0 2.75 0 0 4 0.97
6 69 50 18 56 21 0 2.75 0 1 3 0.95
7 72 36 38 75 5 29 3.75 0 3 1 0.94
8 65 63 60 75 34 29 4.50 1 3 0 0.92
9 61 24 22 82 0 17 2.75 0 1 3 0.96
10 76 75 46 85 38 79 4.75 2 2 0 0.95
11 71 67 58 83 11 73 4.50 2 2 0 0.93
12 78 51 32 82 29 29 3.75 0 3 1 0.95
13 79 69 79 88 46 94 5.50 3 1 0 0.91
14 72 25 14 76 19 0 3.00 0 1 3 0.98
15 72 44 20 76 33 75 3.50 0 3 1 0.97
16 76 65 23 82 20 77 3.75 0 4 0 0.94
17 74 65 24 82 32 29 3.75 0 3 1 0.97
18 57 32 40 78 22 0 3.25 0 3 1 0.95
19 64 29 19 72 16 0 3.00 0 1 3 0.93
20 57 40 2 17 1 21 2.25 0 0 4 0.97
21 67 49 16 74 30 0 3.00 0 1 3 0.96
22 65 21 13 75 13 0 2.75 0 1 3 0.97
23 56 13 2 42 1 0 2.00 0 0 4 0.97
24 54 24 6 61 7 0 2.25 0 0 4 0.96
25 57 33 7 76 8 19 2.50 0 0 4 0.97
26 68 19 18 69 0 33 2.75 0 0 4 0.96
27 40 3 3 26 2 0 1.75 0 0 4 0.96
28 67 39 12 61 27 27 3.25 0 2 2 0.96
29 56 6 11 65 11 0 2.25 0 0 4 0.96
30 67 38 16 74 24 8 3.00 0 2 2 0.95
31 68 36 10 64 1 0 2.75 0 1 3 0.97
32 58 53 52 60 20 71 4.25 0 4 0 0.93
33 64 44 1 33 1 0 2.25 0 0 4 0.97
34 71 63 51 76 32 44 4.25 1 3 0 0.87
35 76 74 76 86 45 65 5.00 3 1 0 0.87
36 68 51 56 61 33 85 4.50 1 3 0 0.91
37 40 19 20 58 13 31 2.50 0 0 4 0.97
38 74 63 59 78 18 60 4.50 1 3 0 0.95
30 Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002) British Society of Gastroenterology (BSG), Association of Coloproctology for Great Britain and Ireland (ACPGBI) UK 2010 2002 UNa, b
31 Suggested screening guidelines for familial colorectal cancer UK Cancer Family Study Group UK 1995 NO
32 S3 guidelines for colorectal carcinoma: results of an evidence-based consensus conference on February 6/7, 2004 and June 8/9, 2007 (for the topics Ⅳ, Ⅵ and Ⅶ) German Society for Digestive and Metabolic Diseases (DGVS), German Cancer Society (DKG) Germany 2010 UNa
33 Colorectal cancer screening for men and women aged 60 to 69 Cancer Society of Finland Finland 2018 NO
34 SIGN 126·Diagnosis and management of colorectal cancer Scottish Intercollegiate Guidelines Network (SIGN) Scotland 2016 YES
35 Clinical practice guidelines for the prevention, early detection and management of colorectal cancer National Health and Medical Research Council (NHMRC) Australia 2016 YES
36 An updated Asia Pacific Consensus recommendations on colorectal cancer screening Asia Pacific Working Group Asia 2015 2008 YES
37 Cancer prevention in Asia: resource-stratified guidelines from the Asian Oncology Summit 2013 Fifth Asian Oncology Summit Asia 2013 NO
38 Korean guidelines for colorectal cancer screening and polyp detection Korean Multi-Society Take Force Korea 2012 YES
39 Clinical practice guidelines: management of colorectal carcinoma Malaysia Health Technology Assessment Section (MaHTAS) Malaysia 2017 UNc
40 National guidelines for colorectal cancer screening in Saudi
Arabia with strength of recommendations and quality of
evidence		 Saudi Society of Colon & Rectal Surge-ry, etc. Saudi 2015 YES
41 中国结直肠肿瘤早诊筛查策略专家共识 中国抗癌协会大肠癌专业委员会 China 2018 NO
42 中国临床肿瘤学会:结直肠癌诊疗指南2017版 中国临床肿瘤学会 China 2017 NO
43 中国早期结直肠癌及癌前病变筛查与诊治共识 中华医学会多协作组 China 2015 NO
44 中国早期结直肠癌筛查及内镜诊治指南 中华医学会消化内镜学分会联合中国抗癌协会肿瘤内镜学专业委员会 China 2015 NO
45 中国大肠肿瘤筛查、早诊早治和综合预防共识意见 中华医学会消化病学分会 China 2011 NO
46 Recommendations on prevention and screening for colorectal cancer in Hong Kong Cancer Expert Working Group on Can-cer Prevention and Screening (CEWC) Hong
Kong		 2018 NO
[1] World Health Organization.Cancer [EB/OL]. [2018/12/13] .
[2] Chen WQ, Zeng HM, Zheng RS , et al. Cancer incidence and mortality in china, 2007[J]. Chin J Cancer Res, 2012,24(1):1-8.
doi: 10.1007/s11670-012-0001-6
[3] 郑荣寿, 张思维, 吴良有 , 等. 中国肿瘤登记地区2008年恶性肿瘤发病和死亡分析[J]. 中国肿瘤, 2012,21(1):1-12.
[4] 陈万青, 张思维, 郑荣寿 , 等. 中国2009年恶性肿瘤发病和死亡分析[J]. 中国肿瘤, 2013,22(1):2-12.
[5] 陈万青, 张思维, 曾红梅 , 等. 中国2010年恶性肿瘤发病与死亡[J]. 中国肿瘤, 2014,23(1):1-10.
[6] 陈万青, 郑荣寿, 曾红梅 , 等. 2011年中国恶性肿瘤发病和死亡分析[J]. 中国肿瘤, 2015,24(1):1-10.
[7] 陈万青, 郑荣寿, 张思维 , 等. 2012年中国恶性肿瘤发病和死亡分析[J]. 中国肿瘤, 2016,25(1):1-8.
[8] 陈万青, 郑荣寿, 张思维 , 等. 2013年中国恶性肿瘤发病和死亡分析[J]. 中国肿瘤, 2017,26(1):1-7.
[9] Institute of Medicine(US). Committee to Advise the Public Health Service on Clinical Practice Guidelines. Field MJ, Lohr KN. Clinical practice guidelines: directions for a new program[M]. Washington, DC: National Academies Press, 1990.
[10] Institute of Medicine(US) . Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. Graham R, Man-cher M, Wolman D , et al. Clinical practice guidelines we can trust [M]. Washington, DC: National Academies Press, 2011.
[11] Shekelle PG . Clinical practice guidelines: what’s next?[J]. JAMA, 2018,320(8):757-758.
doi: 10.1001/jama.2018.9660
[12] 胡晶, 詹思延 . 中国临床实践指南制定的现状与建议[J]. 中国循证心血管医学杂志, 2013,5(3):217-218.
[13] 林夏, 杨克虎, 陈耀龙 , 等. 中国临床实践指南的现状与思考[J]. 中国循证医学杂志, 2017,17(5):497-500.
[14] 李江, 苏凯, 李放 , 等. 肺癌筛查领域指南方法学质量的系统评价[J]. 中国肺癌杂志, 2016,19(10):692-699.
[15] 李江, 唐威, 李霓 , 等. 乳腺癌筛查指南方法学质量和报告质量的系统评价[J]. 中国循证医学杂志, 2018,18(6):629-636.
[16] Ebell MH, Thai TN, Royalty KJ . Cancer screening recommendations: an international comparison of high income countries[J]. Public Health Rev, 2018,39(1):7.
doi: 10.1186/s40985-018-0080-0
[17] 胡晶, 陈茹, 谢雁鸣 , 等. 科学和规范的改编临床实践指南[J]. 中国循证儿科杂志, 2012,7(3):226-230.
[18] 张珊瑚 . 产后出血临床指南的循证评价及实用优化研究[D]. 甘肃: 兰州大学, 2014.
[19] WHO. WHO handbook for guideline development[M]. 2nd ed. Geneva: World Health Organization, 2014.
[20] Brouwers MC, Kho ME, Browman GP , et al. AGREE Ⅱ: advancing guideline development, reporting, and evaluation in health care[J]. Prev Med, 2010,51(5):421-424.
doi: 10.1016/j.ypmed.2010.08.005
[21] 韦当, 王聪尧, 肖晓娟 , 等. 指南研究与评价(AGREEⅡ)工具实例解读[J]. 中国循证儿科杂志, 2013,8(4):316-319.
[22] 乔舰 . 组内相关系数的理论基础及建模应用[J]. 统计与信息论坛, 2016,31(11):44-48.
[23] Bacchus CM, Dunfield L, Gorber SC , et al. Recommendations on screening for colorectal cancer in primary care[J]. CMAJ, 2016,188(5):340-348.
doi: 10.1503/cmaj.151125
[24] Bibbins-Domingo K, Grossman DC, Curry SJ , et al. Screening for colorectal cancer: US preventive services task force recommendation statement[J]. JAMA, 2016,315(23):2564-2575.
doi: 10.1001/jama.2016.5989
[25] 王振军, 付李缘 . 大肠癌筛查共识与争议[J]. 临床外科杂志, 2018,26(10):721-723.
[26] 陈宏达, 卢明, 代敏 . 我国结直肠癌人群筛查参与率现状及影响因素探讨[J]. 华西医学, 2018,33(12):1-5.
[27] Leddin D, Lieberman DA, Tse F , et al. Clinical practice guideline on screening for colorectal cancer in individuals with a family history of nonhereditary colorectal cancer or adenoma: The Cana-dian Association of Gastroenterology Banff Consensus[J]. Gastroenterology, 2018,155(5):1325-1347.
doi: 10.1053/j.gastro.2018.08.017
[28] Sung JJ, Ng SC, Chan FK , et al. An updated Asia Pacific Consensus Recommendations on colorectal cancer screening[J]. Gut, 2015,64(1):121-132.
doi: 10.1136/gutjnl-2013-306503
[29] Lee BI, Hong SP, Kim SE , et al. Korean guidelines for colorectal cancer screening and polyp detection[J]. Clin Endosc, 2012,45(1):25-43.
doi: 10.5946/ce.2012.45.1.25
[1] Ya-nan ZHAO,Hui-yun FAN,Xiang-yu WANG,Ya-nan LUO,Rong ZHANG,Xiao-ying ZHENG. Early death and causes of death of patients with autism spectrum disorders: A systematic review [J]. Journal of Peking University (Health Sciences), 2023, 55(2): 375-383.
[2] Jia-min WANG,Qiu-ping LIU,Ming-lu ZHANG,Chao GONG,Shu-dan LIU,Wei-ye CHEN,Peng SHEN,Hong-bo LIN,Pei GAO,Xun TANG. Effectiveness of different screening strategies for type 2 diabete on preventing cardiovascular diseases in a community-based Chinese population using a decision-analytic Markov model [J]. Journal of Peking University (Health Sciences), 2022, 54(3): 450-457.
[3] MU Dong-liang,XUE Cheng,AN Bin,WANG Dong-xin. Epidural block associated with improved long-term survival after surgery for colorectal cancer: A retrospective cohort study with propensity score matching [J]. Journal of Peking University (Health Sciences), 2021, 53(6): 1152-1158.
[4] LIU Qiu-ping,CHEN Xi-jin,WANG Jia-min,LIU Xiao-fei,SI Ya-qin,LIANG Jing-yuan,SHEN Peng,LIN Hong-bo,TANG Xun,GAO Pei. Effectiveness of different screening strategies for cardiovascular diseases prevention in a community-based Chinese population: A decision-analytic Markov model [J]. Journal of Peking University (Health Sciences), 2021, 53(3): 460-466.
[5] Hang-ci ZHENG,Xiao-tong LI,Peng MEN,Xiang MA,Qiang WANG,Yao-long CHEN,Suo-di ZHAI. Selecting and defining the clinical questions and outcomes of Guideline for the Emergency Treatment of Anaphylaxis [J]. Journal of Peking University (Health Sciences), 2020, 52(4): 715-718.
[6] Bao-qi ZENG,Shu-qing YU,Yao CHEN,Wei ZHAI,Bin LIU,Si-yan ZHAN,Feng SUN. Safety of biological valves for aortic valve replacement: A systematic review and meta-analysis [J]. Journal of Peking University (Health Sciences), 2020, 52(3): 547-556.
[7] SI Ya-qin, TANG Xun, ZHANG Du-dan, HE Liu, CAO Yang, WANG Jin-wei, LI Na, LIU Jian-jiang, GAO Pei, HU Yong-hua. Effectiveness of different screening strategies for primary prevention of cardiovascular diseases in a rural northern Chinese population [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 443-449.
[8] GAO Ming-Yue, YANG Min, KUANG Wei-Hong, QIU Pei-Yuan. Factors and validity analysis of Mini-Mental State Examination in Chinese elderly people [J]. Journal of Peking University(Health Sciences), 2015, 47(3): 443-449.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd