Background: the colorectal cancer screening guidelines worldwide are generally large in number, low in quality, different in statements, and so are the guidelines in China.
Objectives: firstly, to systematically review and assess the quality of guidelines for colorectal cancer screening worldwide. And then to provide suggestions and recommendations for the development of evidence-based guidelines in China according to the content and limitation of current evidence-based guidelines around the world. Finally, to establish the theoretical framework for the evaluation of colorectal cancer screening and the key question list for the development of evidence-based guidelines in China.
Methods: we used systematic review to collect all the guidelines for colorectal cancer screening and then used Appraisal of Guidelines for Research and Evaluation Ⅱ to evaluate the methodological quality of these guidelines. Then we introduced the evidence-based guidelines in detail which met the criteria based on World Health Organization guideline development handbook and formulated the draft list of key questions for the development of evidence-based guidelines. Finally, we used the Delphi method to determine the list of key questions in developing evidence-based guidelines of colorectal cancer screening and the theoretical framework for the evaluation of colorectal cancer screening.
Results: we finally included 46 guidelines in our analysis, among which five are from mainland China. The results are quite different among these guidelines. The consistency of the evaluation results among four reviewers were relatively high. A total of eight guidelines met the criteria of evidence-based guideline defined in our study, with some differences in recommendation statements, such as screening tools, selection of high-risk groups and grade of recommendation. Totally, we collected 34 questionnaires with experts from clinical and epidemiological fields. The average experts’ authority coefficient was 0.81, indicating a high degree of authority. The concentration of opinions on all items in the questionnaire was relatively high, with the full score ratio greater than 75% and the coefficient of variation less than 0.3. The list of key questions on evidence-based guidelines for colorectal cancer screening has been divided into six parts, which covers the issues that need to be considered in the development of evidence-based colorectal cancer screening guidelines in China.
Conclusions: the key question list for evidence-based guideline development and the evaluation framework for colorectal cancer screening in our study can be applied to the development of evidence-based guidelines for colorectal cancer screening in the future, as well as the development of evidence-based guidelines for other cancer screening in China.
Patient or healthcare consumer involvement: none