This article is more than 5 years old. Information may no longer be current.
Flexible sigmoidoscopy associated with decrease in colorectal cancer incidence, mortality
Click Here to Manage Email Alerts
Patients who underwent flexible sigmoidoscopy screening were less prone to colorectal cancer or death from the condition than those who did not in a recent study.
Researchers randomly assigned 154,900 patients aged 55 to 74 years to receive either flexible sigmoidoscopy with follow-up screenings after 3 or 5 years (n=77,445) or standard care between 1993 and 2001. The incidence of colorectal cancer and death were collected during a median follow-up of 11.9 years.
Among patients who received screening, 83.5% received flexible sigmoidoscopy at baseline and 54% underwent the follow-up screening. In the screening group, 1,012 cases of colorectal cancer occurred, with an incidence rate of 11.9 cases per 10,000 person-years, compared with 15.2 cases per 10,000 person-years for 1,287 cases in the usual-care group (RR=0.79; 95% CI, 0.72-0.85). This incidence rate reduction included both distal (RR=0.71; 95% CI, 0.64-0.80) and proximal colorectal cancer (RR=0.86; 95% CI, 0.76-0.97).
Patients with cancer detected via screening (75.4%) were more likely to have stage I or II cancer compared with unscreened patients (50.9%, P<.001) or patients who were screened but whose tumors were undetected (50.7%, P<.001). Distal cancer also was more common among screened patients with detected tumors (82.8%) compared with never-screened patients (52.8%) and screened patients with undetected tumors (31.6%)(P<.001).
Death from cancer occurred in 2.9 cases for every 10,000 person-years and resulted in 252 deaths in the screening group, compared with 3.9 per 10,000 person-years for 341 deaths in the usual-care group (RR=0.74; 95% CI, 0.63-0.87). This included a 50% reduction in deaths from distal colorectal cancer (87 vs. 175, RR=0.50; 95% CI, 0.38-0.64), but no significant reduction in proximal cancer mortality (143 vs. 147 deaths, RR=0.97; 95% CI, 0.77-1.22).
“Screening with flexible sigmoidoscopy, in conjunction with colonoscopy [predominantly] for diagnosis and management after abnormal test results, was associated with a significant and clinically important decrease in colorectal cancer incidence and mortality,” the researchers concluded.
Click Here to Manage Email Alerts