Screening for Colorectal Cancer May Reduce Risk, Death

Flexible sigmoidoscopy screening for colorectal cancer reduced cases and deaths from the condition

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Colorectal cancers are often highly treatable and preventable, particularly with regular screenings. One type of screening may reduce the rate of these cancers.

While colonoscopy is the most common screening method in the United States, a new study found benefits associated with flexible sigmoidoscopy.

That method of screening cut down on both cases of colorectal cancer and death from the condition.

"Discuss colorectal screening with a gastroenterologist."

The study was written by Øyvind Holme, MD, of Sorlandet Hospital in Kristiansand, Norway, and colleagues.

The team focused on colorectal cancer screening using flexible sigmoidoscopy.

Flexible sigmoidoscopy uses a thin, flexible tube to inspect for and remove adenomas, or benign tumors. Adenomas can develop into cancer.

The researchers compared rates of colorectal cancer and death from the condition in patients screened with sigmoidoscopy and patients who had no screening.

For the study, 10,283 patients were randomly assigned flexible sigmoidoscopy; 10,289 received a combo of sigmoidoscopy and blood testing; and 78,220 had no interventions.

The study authors performed initial screenings from 1999 to 2000, with follow-up ending in 2011.

After an average of 11 years, 71 participants in the groups that received screening died of colorectal cancer. In the group with no screening, 330 participants died of colorectal cancer.

Colorectal cancer was diagnosed in 253 patients from the screening group and 1,086 in the group that did not receive screening.

The authors concluded that, compared to no screening, use of flexible sigmoidoscopy reduced cases of colorectal cancer by 20 percent. Screening reduced death from colorectal cancer by 27 percent.

The addition of the blood testing caused no significant difference, the authors noted.

The study was published online Aug. 12 in JAMA.

In an editorial about the study published in the same journal, Allan Brett, MD, of the University of South Carolina School of Medicine in Columbia, SC, wrote that the Norwegian study highlighted an irony for American doctors.

Despite the apparent effectiveness of flexible sigmoidoscopy, it's not the standard screening method in America, he noted.

“By far, colonoscopy has become the most commonly recommended and performed endoscopic colorectal screening tool in the United States, whereas screening by sigmoidoscopy has all but vanished,” he wrote.

Dr. Brett attributed that discrepancy to insurance coverage for colonoscopy.

Funding was provided by the Norwegian government, the Norwegian Cancer Society, the Research Council of Norway, the South-East Regional Health Authority of Norway, the Fulbright Foundation, Sorlandet Hospital Kristiansand and the National Institutes of Health.

One study author received equipment from private companies.

Review Date: 
August 11, 2014
Last Updated:
August 12, 2014