Abstract
Colorectal Cancer Screening Using Flexible Sigmoidoscopy: United Kingdom Study Demonstrates Significant Incidence and Mortality Benefit
Highlights
This widely held sentiment, expressed in an influential editorial published in the New England Journal of Medicine in 2000 [1], helps explain the dramatic drop in rates of flexible sigmoidoscopy in Canada and the United States, at the same time that colonoscopy rates have increased [2,3,4]
In a per-protocol analysis that included the 71% of patients randomly assigned to flexible sigmoidoscopy who completed screening, the incidence of colorectal cancer (CRC) was reduced by 33% and mortality by 43%
The magnitude of the incidence and mortality reduction seen in the United Kingdom (UK) study is remarkable for several reasons
Summary
This widely held sentiment, expressed in an influential editorial published in the New England Journal of Medicine in 2000 [1], helps explain the dramatic drop in rates of flexible sigmoidoscopy in Canada and the United States, at the same time that colonoscopy rates have increased [2,3,4]. The UK trial investigators randomly assigned 170,432 individuals 55 to 64 years of age to either once-only flexible sigmoidoscopy or no screening in a 1:2 ratio. In the intention-to-treat analysis, CRC incidence in the intervention group was reduced by 23% (HR 0.77; 95% CI 0.70 to 0.84) and mortality by 31% (HR 0.69; 95% CI 0.59 to 0.82).
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