Abstract

To understand how much screening endoscopy (sigmoidoscopy or colonoscopy) reduces colorectal cancer incidence and mortality, there has been no evidence from a randomised trial of sufficient size and duration to draw strong conclusions. The reduction in colorectal cancer mortality of 60–70% for lesions within reach of the sigmoidoscope is based on case-control research.1 The reduction in the incidence of colorectal cancer of 76–90% for colonoscopy is based on a study that used historical controls,2 a design that can inflate estimates of benefit.

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