Prepared for:

Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services

540 Gaither Road

Rockville, MD 20850

www.ahrq.gov

Prepared by:

Oregon Evidence-based Practice Center

Center for Health Research, Kaiser Permanente

3800 North Interstate Avenue

Portland, OR 97227

Investigators:

Evelyn P. Whitlock, MD MPH

Jennifer Lin, MD

Elizabeth Liles, MD

Tracy Beil, MS

Rongwei Fu, PhD

Elizabeth O'Connor, PhD

Rebecca Newton Thompson, MD, MSc

Taryn Cardenas, BS

AHRQ Publication No. 08-05-05124-EF-1

October 2008

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10057-I). The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

The final version of this updated systematic review was submitted to the Agency for Healthcare Research and Quality in May 2008. This report was not made available to the public until the United States Preventive Services Task Force (USPSTF) updated recommendation for colorectal cancer screening was finalized and published through Annals of Internal Medicine (electronically on October 7, 2008 and in print on November 4, 2008).

A manuscript derived from this report statement (Whitlock, E.P., Lin J.S., Liles, E, Beil TL, Fu R. Screening for Colorectal Cancer: An updated systematic review for the US Preventive Services Task Force. Ann of Intern Med 2008; 149:638-658) was also published through Annals of Internal Medicine simultaneously with the updated USPSTF recommendation. This manuscript contains additional data not available at the time this evidence report was finalized, including the published results from the largest study of screening computed tomographic (CT) colonography conducted, the American College of Radiology Imaging Network (ACRIN) National CT colonography Trial 6664. Data from the ACRIN study have been incorporated into the manuscript to update the estimates of CT colonography sensitivity and specificity, referral rates after CT colonography, extracolonic findings with CT colonography, and harms with CT colonography and from screening colonoscopy. Please refer to the manuscript for updated information.

Suggested citation: Whitlock, EP, Lin J, Liles E, Beil T, Fu R, O'Connor E, Thompson RN, Cardenas T. Screening for Colorectal Cancer: An Updated Systematic Review. Evidence Synthesis No. 65, Part 1. AHRQ Publication No. 08-05124-EF-1. Rockville, Maryland, Agency for Healthcare Research and Quality, October 2008.