European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition – Principles of evidence assessment and methods for reaching recommendations

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The principles of evidence assessment and methods for reaching recommendations are presented here to promote international discussion and collaboration by making the principles and methods used in developing the guidelines known to a wider professional and scientific community. Following this methodology in the future updating of the guidelines has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multidisciplinary diagnosis and management of the disease.

Keywords

mass screening - colorectal neoplasms - evidence-based methodology - systematic review - population-based programmes

• References

• 1 Council of the European Union. Council Recommendation of 2 December 2003 on cancer screening (2003/878/EC). Off J Eur Union; 2003: 34-38
• 2 Cochrane Effective Practice and Organisation of Care Group (EPOC). Data Collection Checklist. 2002 http://www.epoc.cochrane.org/en/handsearchers.html
• 3 Ferlay J, Shin HR, Bray F et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. [Internet] Lyon, France: International Agency for Research on Cancer; 2010 Available from: http://globocan.iarc.fr Accessed on 05/04/2012
• 4 Greenhalgh T. Why read papers at all? How to read a paper. The basics of evidence-based medicine. BMJ Books; 1997: 1-14
• 5 Higgins JPT, Altman DG. Assessing risk of bias in included studies. In: Higgins JPT, Green S, (eds.) Cochrane Handbook for Systematic Reviews of Interventions. UK: Wiley-Blackwell; 2008
• 6 Minozzi S, Armaroli P, Banzi R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis – First edition. Appendix 1: Systematic evidence review. 2010 http://bookshop.europa.eu/en/european-guidelines-for-quality-assurance-in-colorectal-cancer-screening-and-diagnosis-pbND3210390/ Accessed 11/2/2012
• 7 Moher D, Cook DJ, Eastwood S et al. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet 1999; 354: 1896-1900
• 8 O'Connor D, Green S, Higgins JPT. Defining the review question and developing criteria for including studies. In: Higgins JPT, Green S, (eds.) Cochrane Handbook for Systematic Reviews of Interventions (Wiley Cochrane Series ). UK: Wiley-Blackwell; 2008
• 9 Richardson WS, Wilson MC, Nishikawa J et al. The well-built clinical question: a key to evidence-based decisions. ACP J Club 1995; 123: A12-A13
• 10 Segnan N, Patnick J, von Karsa L (eds.) European guidelines for quality assurance in colorectal cancer screening and diagnosis – First edition. Luxembourg: European Commission, Publications Office of the European Union; 2010
• 11 Shiffman RN, Shekelle P, Overhage JM et al. Standardized reporting of clinical practice guidelines: a proposal from the Conference on Guideline Standardization. Ann Intern Med 2003; 139: 493-498
• 12 von Karsa L, Anttila A, Ronco G et al. Cancer Screening in the European Union. Report on the implementation of the Council Recommendation on Cancer Screening – First Report. Luxembourg: European Commission; 2008 http://ec.europa.eu/health/archive/ph_determinants/genetics/documents/cancer_screening.pdf Accessed 11/2/2012
• 13 von Karsa L, Lignini TA, Patnick J et al. The dimensions of the CRC problem. Best Pract Res Clin Gastroenterol 2010; 24: 381-396
• 14 Wells GA, Shea B, O'Connell D et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2010 http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm
• 15 Whiting P, Rutjes AW, Reitsma JB et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 2003; 3: 25
• 16 Wilson JM, Jungner YG. Principles and practice of mass screening for disease. World Health Organization; 1968 http://whqlibdoc.who.int/php/WHO_PHP_34.pdf Accessed 11/2/2012