Colorectal Cancer Screening Cuts to the Chase

Colorectal cancer deaths reduced with sigmoidoscopy

(RxWiki News) In terms of colorectal cancer, "the most effective screening test is the one that people choose to take.”

So says Director of the National Cancer Institute's (NCI) Division of Cancer Prevention, Barnett Kramer, MD. And one option works pretty well.

A 20-year study involving thousands of people found that flexible sigmoidoscopy effectively protects against colorectal cancer, the second-leading cause of cancer-related death in the United States.

"Talk to your doctor about colorectal cancer screening."

The NCI research found that the procedure, which is less invasive and expensive than colonoscopy, reduced both colorectal cancer incidence by 26 percent and death rates by 21 percent.

Results from this study appeared online, ahead of print, on May 21, 2012, in the New England Journal of Medicine.

Sigmoidoscopy examines only the lower part of the colon known as the distal region. It requires less preparation than colonoscopy and no sedation. It can be performed in a physician's office and costs hundreds of dollars less than colonoscopy, which can range in price from $1,000-3,000.

“The most important message is that, regardless of modality chosen, colorectal cancer screening lowers mortality from colorectal cancer, and all individuals 50 and over should be screened,” said study author Christine Berg, MD, chief of NCI's Early Detection Research Group and project officer of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.

For this study, 154,900 men and women between the ages of 55 and 74 were randomly assigned to receive flexible sigmoidoscopy screening or usual care (screening only when requested or recommended by physician). 

Those who received the sigmoidoscopy were screened upon entering the study and then again 3-5 years later. Participants were followed for about 12 years to collect data on cancer diagnoses and deaths. 

Researchers found that people in the screening group had a 21 percent lower incidence of colorectal cancer and a 26 percent lower rate of colorectal cancer mortality than those in the usual care group.

Looked at differently, using sigmoidoscopy to screen 1,000 people twice over a 10-year period would result in about three fewer new cases and one less death from colorectal cancer, compared to people who didn't receive regular screenings.

One of the researchers involved in this study reported having financial relationships with a number of pharmaceutical manufacturers.

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Review Date: 
May 22, 2012