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Flexible sigmoidoscopy CRC screening should target older patients with more than 10-year life expectancy
Colorectal cancer screening using flexible sigmoidoscopy is most appropriate for older adults with a life expectancy greater than 10 years, according to recent study data.
Aiming to determine the time to benefit for flexible sigmoidoscopy screening, researchers performed a survival meta-analysis of four population-based randomized controlled trials (total n = 459,814; range, 34,272-170,432) that compared flexible sigmoidoscopy screenings vs. no screening. Patient age was similar across trials (range, 50-74 years) as was follow-up (11.2-11.9 years) and relative risk for colorectal cancer (CRC)-related mortality (0.69-0.78 with flexible sigmoidoscopy screening).
They found that for every 1,000 individuals screened at 5 years, 0.3 CRC-related deaths were prevented, and for every 1,000 screened at 10 years, 1.2 CRC-related deaths were prevented. An absolute risk reduction of 0.0002 (one CRC-related death prevented for every 5,000 flexible sigmoidoscopy screenings) was observed at 4.3 (95% CI, 2.8-5.8) years, and an absolute risk reduction of 0.001 (one CRC-related death prevented for every 1,000 flexible sigmoidoscopy screenings) was observed at 9.4 (95% CI, 7.6-11.3) years.
“It takes nearly 10 years after screening flexible sigmoidoscopy to observe an absolute risk reduction in [CRC]-related mortality of 0.001,” the researchers concluded. “This suggests that screening flexible sigmoidoscopy should be targeted to those older adults whose life expectancy exceeds 10 years.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.