Screening patients at increased risk not linked to decrease in CVD-, cancer-, diabetes-linked death
THURSDAY, Oct. 4 (HealthDay News) -- For middle-aged adults at high risk of type 2 diabetes, invitation to screening is not associated with a decrease in mortality, according to a study published online Oct. 4 in The Lancet.
Rebecca K. Simmons, Ph.D., from the MRC Epidemiology Unit in Cambridge, U.K., and colleagues assessed the effect of a population-based stepwise screening program on mortality in a parallel group cluster-randomized trial involving 33 general practices in eastern England. Fifteen practices were assigned to screening followed by intensive multifactorial treatment for those diagnosed with diabetes; 13 were assigned to screening plus routine care of diabetes; and five practices made up a no-screening control group. A total of 20,184 adults, aged 40 to 69 years, at high risk of prevalence of undiagnosed diabetes constituted the study population.
The researchers found that 94 percent of the 16,047 high-risk individuals in screening practices were invited for screening, 73 percent attended, and 3 percent were diagnosed with diabetes. During a median of 9.6 years of follow-up there were 1,532 deaths in the screening practices and 377 in control practices, for a hazard ratio for death of 1.06 (95 percent confidence interval, 0.90 to 1.25). Invitation to screening was not associated with a significant reduction in cardiovascular-, cancer-, or diabetes-related mortality.
"In conclusion, invitation to a single round of screening for type 2 diabetes in high-risk individuals in U.K. general practice might benefit the minority with detectable disease but was not associated with a reduction in all-cause or diabetes-related mortality over 10 years," the authors write.
The study was partially funded by Bio-Rad. Two authors disclosed financial ties to Ely Lilly and/or Novo Nordisk.
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