A comprehensive systematic review of colorectal cancer screening clinical practices guidelines and consensus statements

Abstract

High-quality clinical practice guidelines (CPGs) and consensus statements (CSs) are essential for evidence-based medicine. The purpose of this systematic review was to appraise the quality and reporting of colorectal cancer (CRC) screening CPGs and CSs. After prospective registration (Prospero no: CRD42021286156), a systematic review searched CRC guidances in duplicate without language restrictions in ten databases, 20 society websites, and grey literature from 2018 to 2021. We appraised quality with AGREE II (% of maximum score) and reporting with RIGHT (% of total 35 items) tools. Twenty-four CPGs and 5 CSs were analysed. The median overall quality and reporting were 54.0% (IQR 45.7–75.0) and 42.0% (IQR 31.4–68.6). The applicability had low quality (AGREE II score <50%) in 83% of guidances (24/29). Recommendations and conflict of interest were low-reported (RIGHT score <50%) in 62% guidances (18/29) and 69% (20/29). CPGs that deployed systematic reviews had better quality and reporting than CSs (AGREE: 68.5% vs. 35.5%; p = 0.001; RIGHT: 74.6% vs. 41.4%; p = 0.001). In summary, CRC screening CPGs and CSs achieved low quality and reporting. It is necessary a revision and an improvement of the current guidances. Their development should apply a robust methodology using proper guideline development tools to obtain high-quality evidence-based documents.

Early Screening of Colorectal Precancerous Lesions Based on Combined Measurement of Multiple Serum Tumor Markers Using Artificial Neural Network Analysis

“…Delayed diagnosis and treatment significantly reduce patient survival time. CRC is mainly diagnosed by endoscopy and pathological biopsy combined with clinical symptoms [26]. Although these methods are effective, they are invasive, which might cause harm to patients and are thus not suitable for dynamic monitoring of disease.…”

Assessment of the methodological, recommendation and reporting quality of global guidelines for neck pain and synthesis of evidence and recommendations: a systematic review protocol

“…For a broad collection of CPGs for neck pain, we referred to high-quality systematic reviews 29–31 of CPGs without language restrictions for inclusion. And all the databases mentioned in these reviews were collected for retrieval.…”

Optimization of colorectal cancer screening strategies: New insights

“…However, recent updates from the American Cancer Society and the United States Preventive Service Task Force have extended screening recommendations to include individuals aged 45 and older due to an increase in the incidence of CRC among younger adults[ 3 ]. Furthermore, in a recent systematic review of 24 clinical practice guidelines and five consensus statements, the median overall quality and reporting were 54.0% and 42.0% and the applicability had low quality in 83% of guidelines (24/29) which necessitates a revision and an enhancement of the current guidelines[ 16 ].…”