THE PARTICIPATION RATE BETWEEN CT COLONOGRAPHY AND COLONOSCOPY IN SCREENING POPULATION

Background To compare the participation rate between CT colonography and colonoscopy in screening population among randomized controlled trials (RCTs). Methods A search was performed using the PubMed, Web of Science, and Cochrane databases. Studies including unselected screening populations reporting participation rates were limited to randomized controlled trials published in English. The quality of the included articles was ranked in accordance with the Jadad composite scale. Stata 12.0 was used to analyze the data. Risk ratios (RR) were used to compare trials and assess the value of the screening method used. The Higgins I2 statistic was used to determine the total variation across studies due to heterogeneity. If the I2 statistic was ≤50%, the findings among the studies were considered homogeneous, and the fixed effects model was used to pool studies; otherwise, the random-effects model was used. Results Six of 760 studies were included in this meta-analysis (figure 1). There were 17958 invitees in total. Participation rates were 29.0% (2716/9378) for CT colonography and 21.5% (1841/8580) for colonoscopy, and the difference was statistically significant (RR=1.241; 95% CI:1.001 to 1.538; P=0.049; I2=90.4%, (figure 1)). We excluded one study used flexible sigmoidoscopy (FS), but the participation rate was not with statistically significantly different between the two groups (pooled RR=1.266; 95% CI:0.988 to 1.623; P=0.063; I2=89.8%, (figure 3)). However, when the two low-quality studies which also were community-based studies excluded again in these six studies, we found that the participation rate in the CT colonography group was significantly higher than that in the colonoscopy group (pooled RR=1.327; 95% CI:1.034 to 1.702; P=0.026; I2=93.4%). Conclusions The participation rate in colorectal cancer screening with CT colonography was significantly higher than with colonoscopy. This rate also has a trend over time and sample size. In the future, more large-sample RCTs are needed to confirm the reliability of this study.