Sigmoidoscopy Screening For Colorectal Cancer Research Articles

Should we perform sigmoidoscopy for colorectal cancer screening in people under 45 years?

The strategy for preventing colorectal cancer is screening by colonoscopy, which offers a direct way for detection and removal of adenomatous polyps (APs). American College of Gastroenterology guidelines recommend that people aged ≥ 45 years should undergo colonoscopy; however, how to deal with people aged ≤ 45 years is still unknown. To compare the prevalence of APs and high-grade neoplasia between the left and right colon in patients ≤ 45 years. A retrospective observational study was conducted at a single tertiary III hospital in China. This study included patients aged 18-45 years with undergoing initial colonoscopy dissection and pathological diagnosis AP or high-grade neoplasia between February 2014 and January 2021. The number of APs in the entire colon while screening and post-polypectomy surveillance in following 1-3 years were evaluated. A total of 3053 cases were included. The prevalence of APs in the left and right colon was 55.0% and 41.6%, respectively (OR 1.7, 95%CI 1.6-2.4; P < 0.05). For APs with high-grade neoplasia, the prevalence was 2.7% and 0.9%, respectively (OR 3.0, 95%CI 2.0-4.6; P < 0.05). Therefore, the prevalence of APs and high-grade neoplasia in the left colon was significantly higher than in the right colon in patients aged ≤ 45 years. There were 327 patients who voluntarily participated in post-polypectomy surveillance in following 1-3 years, and APs were found in 216 cases (66.1%); 170 cases had 1-3 polyps (52.0%) and 46 cases had > 3 polyps (14.1%; OR 0.3, 95%CI 0.1-0.6; P < 0.05). This study suggests that flexible sigmoidoscopy would be an optimal approach for initial screening in people aged ≤ 45 years and would be a more cost-effective and safe strategy.

Additional offer of sigmoidoscopy in colorectal cancer screening in Germany: rationale and protocol of the decision-analytic modelling approach in the SIGMO study

IntroductionIn Germany, statutory insured persons are entitled to a stool test (faecal immunochemical test (FIT)) or colonoscopy for colorectal cancer (CRC) screening, depending on age and sex, yet participation rates...

Comparative Effectiveness of Fecal Immunochemical Tests versus Flexible Sigmoidoscopy for Colorectal Cancer Screening: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Fecal immunochemical tests (FITs) and flexible sigmoidoscopies are commonly used modalities for colorectal cancer (CRC) screening. We performed a systematic review and meta-analysis to compare the effectiveness of FIT and sigmoidoscopy in CRC screening. PRISMA statement and Cochrane guidelines were followed for this review. Digital dissertation databases were searched from inception till December 1st 2020 and randomized clinical trials comparing the detection rates of CRC for FIT and sigmoidoscopy were included. Outcomes for analysis included participation rates and detection rates of CRC, advanced adenomas and advanced colorectal neoplasia for both screening modalities. Five randomized clinical trials with a total of 261,755 patients were included for the analysis. The participation rate for FIT was significantly higher compared to flexible sigmoidoscopy (OR 2.11, 95% CI 1.29-3.44, p=0.003). In intention-to-screen analysis, the detection rate for advanced colorectal neoplasia was significantly lower with FIT (OR 0.62, 95% CI 0.45-0.84, p=0.002) as compared to flexible sigmoidoscopy but not statistically different for CRC (OR 1.15, 95% CI 0.65-2.02, p=0.63). Despite lower participation amongst patients, CRC screening with flexible sigmoidoscopy leads to higher detection of advanced colorectal neoplasia, when compared to a single round of fecal immunochemical testing.

Key issues that need to be considered while revising the current annex of the European Council Recommendation (2003) on cancer screening.

The 2003 European Council recommendation urging the Member States to introduce or scale up breast, cervical and colorectal cancer screening through an organized population-based approach has had a remarkable impact. We argue that the recommendation needs to be updated for at least two sets of reasons. First, some of the current clinical guidelines include new tests or protocols that were not available at the time of the Council document. Some have already been adopted by organized screening programs, such as newly defined age ranges for mammography screening, Human Papillomavirus (HPV)-based cervical cancer screening, fecal immunochemical test (FIT) and sigmoidoscopy for colorectal cancer screening. Second, the outcomes of randomized trials evaluating screening for lung and prostate cancer have been published recently and the balance between harms and benefits needs to be pragmatically assessed. In the European Union, research collaboration and networking to exchange and develop best practices should be regularly supported by the European Commission. Integration between primary and secondary preventive strategies through comprehensive approaches is necessary not only to maximize the reduction in cancer burden but also to control the rising trend of other noncommunicable diseases sharing the same risk factors.

Predictors of intention translation in flexible sigmoidoscopy screening for colorectal cancer.

This prospective study aimed to identify predictors of intention and subsequent attendance of flexible sigmoidoscopy screening using constructs derived from the Health Belief Model (HBM). A total of 4,330 people aged 54 years and registered at 1 of 83 participating English general practices were sent a preinvitation questionnaire to assess sociodemographics, HBM variables including perceived benefits, barriers, seriousness, health motivation, and external cues to action as well a range of other constructs and personal characteristics known to relate to cancer screening. Of the 1,578 respondents (36.4%), 1,555 (98.5%) answered the intention question: 52.9% stated definitely yes, 38.1% probably yes, 6.8% probably not, and 2.2% definitely not. Intentions were positively associated with a higher score on a scale of benefits (odds ratio [OR] = 4.62; 95% confidence intervals [CI; 3.24, 6.59]) and health motivation, that is, interest in other ways of preventing colorectal cancer (OR = 2.61; 95% CI [1.62, 4.22]), while a higher score on perceived barriers (OR = 0.19; 95% CI [0.12, 0.31]) and currently following recommended healthy lifestyle behaviors (OR = 0.31; 95% CI [0.16, 0.59]) were negatively associated. Attendance was verified for 922 intenders (65.2%) of whom 737 (79.9%) attended. Attendance was predicted by health motivation (OR = 1.75; 95% CI [1.07, 2.86]), perceived benefits (OR = 1.82; 95% CI [1.37, 2.43]), perceived barriers (OR = 0.47; 95% CI [0.32, 0.69]), individual-level deprivation (OR = 0.26; 95% CI [0.14, 0.50]), and having diabetes (OR = 0.48; 95% CI [0.25, 0.94]). This study supported the usefulness of the HBM in predicting cancer screening and was further enhanced by adding non-HBM variables such as individual socioeconomic deprivation and comorbidities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Physicians' view on sigmoidoscopy as an additionally offered method for colorectal cancer screening.

In Germany, colorectal cancer (CRC) screening includes a fecal blood test or colonoscopy, but not a sigmoidoscopy, which has been shown to reduce CRC incidences and mortality. Our aim was to compile physicians' experiences with sigmoidoscopy and their assessments of this procedure being an additional, possible screening method for early CRC detection. At the end of 2015, gastroenterologists and internists in Lower Saxony and North Rhine-Westphalia who regularly perform screening colonoscopies in outpatient care were contacted per mail. Standardized telephone interviews consisting of 17 questions and lasting 10-15 minutes were conducted. Nearly two-thirds (56/87) of the respondents reject sigmoidoscopy as an acceptable early detection method. Compared to colonoscopy, key features of the sigmoidoscopy include more favorable patient-related aspects, while procedural aspects, except sedation, clearly rate in favor of the colonoscopy. In the instance that colonoscopy is rejected, 75 % of the physicians consider a sigmoidoscopy to be a possible alternative. The survey provides important practical insights into outpatient sigmoidoscopy. A majority of the physicians does not support evidence-based sigmoidoscopy for CRC screening. However, individuals who reject a colonoscopy are, in line with the current guideline, identified as a target group for a screening sigmoidoscopy. The benefit from an additionally offered sigmoidoscopy in CRC screening should be further analyzed with special consideration given to the preferences of insurees within the German healthcare system.

Sigmoidoscopy Screening for Colorectal Cancer.

Sigmoidoscopy Screening for Colorectal Cancer.

Flexible sigmoidoscopy in colorectal cancer screening: implications of different colonoscopy referral strategies

Flexible sigmoidoscopy (FS) screening reduces colorectal cancer incidence and mortality. Its potential to detect proximal neoplasms depends on colonoscopy referral. We estimated diagnostic performance of sigmoidoscopy using 12 different referral criteria in detecting colorectal cancer and advanced adenomas. Colonoscopy results from 14,947 participants of screening colonoscopy in Germany were used to derive sensitivity of sigmoidoscopy for colorectal cancer, advanced adenomas (AAs), and any advanced neoplasms in the proximal colon. It was assumed that FS detects the same neoplasms as colonoscopy within its reach and that distal neoplasms would be followed by colonoscopy. In addition, numbers of colonoscopies needed (NCN) to detect one proximal advanced neoplasm were calculated. The most advanced findings during colonoscopy were colorectal cancer in 213 subjects (1.4%), AA in 1539 subjects (10.2%) and non-advanced adenomas in 2988 subjects (19.8%). Without colonoscopy referral, overall sensitivities for any colorectal cancer, advanced adenoma and any advanced neoplasm (proximal or distal) would be 79, 65 and 66%, respectively. These sensitivities could be increased to up to 86, 83 and 84% by the referral strategies investigated. Compared to referral due to advanced adenomas, referral due to non-advanced adenomas would substantially increase the NCN at a modest gain in sensitivity. Sensitivities were higher and NCNs were lower in men than in women for every strategy. In conclusion, colonoscopy referral can substantially increase sensitivity of sigmoidoscopy-based screening, but the gain by referral due to non-advanced adenomas substantially increases NCN compared to referral due to advanced neoplasms only. Major sex differences may call for sex-specific referral strategies.

Is CT Colonography Better Tolerated than Flexible Sigmoidoscopy for Colorectal Cancer Screening?

Is CT Colonography Better Tolerated than Flexible Sigmoidoscopy for Colorectal Cancer Screening?

Simulating results from trials of sigmoidoscopy screening using the OncoSim microsimulation model

IntroductionProjection of the effect of cancer screening interventions are frequently conducted using complex simulation models. It is important that such models demonstrate their ability to replicate observational results on the effect of screening. We present results using the OncoSim-CRC microsimulation model to replicate results from four randomized trials (RCTs) of sigmoidoscopy screening for colorectal cancer (CRC). MethodsThe published results of four RCTs of sigmoidoscopy were reviewed. Two key outcomes were identified: the intention-to-treat hazard ratios (HR) for CRC incidence and CRC mortality for the screening versus control arms. Each RCT study arm was simulated within OncoSim-CRC using the study specific entry criteria, follow-up and observed participation and compliance rates. The ratio of predicted cases (deaths) between intervention arm and control arm was used to estimate the HRs. ResultsThe RCTs differed in the implementation of sigmoidoscopy screening and only one (PLCO) used more than one cycle. All four RCTs found significant reductions, HR <1, in CRC incidence (range 0.77–0.82) and three for CRC mortality (range 0.69–0.78). The four study cohorts were successfully simulated to match the age and sex structure and length of follow-up of the study cohorts. Each OncoSim-CRC trial-specific predicted reduction fell within the confidence intervals for the observed HR for CRC incidence and CRC mortality for the corresponding trial. The predicted ranges of HRs for incidence was 0.74–0.82 and for mortality was 0.66–0.76 for the four trials. ConclusionsOncoSim-CRC predicted reductions in CRC incidence and mortality agreed well with observed in RCTs of sigmoidoscopy screening.

Colonoscopy and Flexible Sigmoidoscopy in Colorectal Cancer Screening and Surveillance

Since the invention of endoscopy in the 1800s, colonoscopy and flexible sigmoidoscopy have evolved into important tools in the diagnosis and treatment of lower gastrointestinal luminal diseases. These two modalities along with biochemical markers and widespread implementation of colorectal cancer (CRC) screening are responsible for the overall downtrend of CRC. However, this downward trend is not as robustly reflected in the right-sided CRC. It is thought that flat lesions in the right colon (sessile serrated polyp (SSA/P)), suboptimal colon preparation, differences in gender, and endoscopic techniques are some of the contributing factors accounting for this difference. In this review, we will summarize the most current literature and guidelines on CRC screening and surveillance. In addition, we will describe the recent advances in endoscopic CRC screening with emphasis on colonoscopy and flexible sigmoidoscopy and the changes they have brought to the CRC landscape in the US.

Flexible sigmoidoscopy: more than a unilateral breast exam?

Upon reviewing the many wonderful articles and perspective pieces in this Special Issue of Digestive Diseases and Sciences prior to publication, it occurred to me that an important method of screening had not been covered. While in 2010 in the USA \6 % of respondents aged 50–75 reported having screening flexible sigmoidoscopy performed within 5 years (an additional 1.3 % had sigmoidoscopy plus fecal occult blood testing) [1, 2], flexible sigmoidoscopy remains part of the menu of screening options recommended by several professional society guidelines [3–6]. Four recent randomized trials also provide (arguably) the largest body of prospective evidence demonstrating the role of colorectal cancer (CRC) screening in reducing CRC-related mortality of any screening method [7–10]. I therefore decided that it was important to at least provide a brief perspective on flexible sigmoidoscopy as a CRC screening tool, including why it is not used more today in the USA. Four large prospective randomized trials of flexible sigmoidoscopy for CRC screening were published in highimpact journals between 2004 and 2014, having been initiated in the 1990s when flexible sigmoidoscopy was a more common screening tool than in the USA today (Table 1) [7–10]. The trials from the UK (the UK Flexible Sigmoidoscopy Trial), Italy (the Italian Randomized Controlled Trial-SCORE), the USA (the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial-PLCO), and Norway (the Norwegian Colorectal Cancer Prevention Trial-NORCAPP) differ in several ways including how participants were recruited, the number of screening examinations performed, degree of screening outside the trial (‘‘contamination’’), and what findings at sigmoidoscopy generated a subsequent colonoscopy. All, however, demonstrated similar relative and absolute reductions in CRC incidence and cancer-related incidence and mortality. The UK Flexible Sigmoidoscopy Screening Trial is a randomized trial which tested the hypothesis that a single flexible sigmoidoscopy screening examination offered at approximately 60 years of age can lower the incidence and mortality of CRC [7]. CRC incidence and mortality were reduced by 23 and 31 %, respectively, in the intention-totreat analysis (33 and 43 %, respectively, based on perprotocol analysis); incidence of cancer of the rectum and sigmoid was reduced by 36 % in the intention-to-treat analysis and 50 % in the per-protocol analysis. These data have resulted in once in a lifetime flexible sigmoidoscopy being included as an option in the UK National Health Service Bowel Cancer Screening Programme (FOBT is the other option). The Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) enrolled 154,900 subjects of age 55–74 years in a prospective randomized trial that compared flexible sigmoidoscopy with repeat screening at 3 or 5 years to a usual-care control group [8]. Flexible sigmoidoscopy reduced CRC incidence by 21 % with a benefit observed in both the proximal and distal colon and reduced overall mortality by 26 % (intention-to-treat analyses). Mortality from distal CRC (distal to the splenic flexure) was reduced by 50 %, whereas mortality from proximal CRC was unaffected. The Italian Randomized Controlled Trial (SCORE) demonstrated that once-only sigmoidoscopy significantly reduced CRC incidence by 18 % and insignificantly reduced mortality by 22 % in intention-to-treat analyses; in R. S. Bresalier (&) Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, Houston, TX 77030, USA e-mail: rbresali@mdanderson.org

PWE-034 Patient-reported Experience Of Comfort And Dignity In Flexible Sigmoidoscopy: Data From The Nhs Bowel Scope Screening Pilot

IntroductionThe NHS Bowel Cancer Screening Programme started flexible sigmoidoscopy (FS) screening (also known as Bowel Scope Screening, BSS) at six centres across England (Gateshead, Guildford, London, Medway, Norwich, Wolverhampton) in...

Flexible Sigmoidoscopy for Colorectal Cancer Screening in Canada

Flexible Sigmoidoscopy for Colorectal Cancer Screening in Canada

Abstract C04: Colorectal cancer screening and long-term lifestyle changes: A randomized controlled trial

Abstract Background: There is concern that cancer screening may result in apparent perception of health security and thereby reduce people's incentives for changes towards a favorable lifestyle. The present large-scale population based trial investigates long-term effects of colorectal cancer screening on lifestyle changes. Methods: The present study evaluated changes in lifestyle after 11-years of follow-up among men and women (aged 50-55 years) randomized to a flexible sigmoidoscopy screening for colorectal cancer or to a no-screening control group in the Norwegian Colorectal Cancer Screening Prevention trial (NORCCAP). The lifestyle factors (including body weight, smoking status, physical exercise and consumption of selected dietary items) were assessed by a questionnaire at inclusion and after three and 11 years, respectively. We tested differences in lifestyle changes over the 11-year follow-up period in single factors and total score (0-4 points, higher score translates to more healthy lifestyle) between individuals randomized to screening and control groups, and between screening participants with positive and negative screening results by logistic regression and ANCOVA analysis, adjusting for covariates including baseline lifestyle differences. Results: A total of 3,043 (44%) individuals randomized to screening and 2,819 (40%) randomized to the control group completed the questionnaires both at inclusion and after 11 years. We found a small, less favorable change in lifestyle in the screening group (total lifestyle score 1.43 at inclusion; 1.58 after 11 years) compared to the control group (total lifestyle score 1.49 at inclusion; 1.67 after 11 years); adjusted difference -0.05 (95% CI -0.09 to -0.01; p=0.029). 11-year change in total lifestyle score was less favorable in screening participants with positive compared to those with negative screening result (adjusted difference -0.16 (95% CI -0.25 to -0.08; p&amp;lt;0.001)). Conclusions: Invitation to colorectal cancer screening has no large long-term adverse effect on lifestyle. However, the present study suggests that patients with positive screening results may be inclined to a less favorable lifestyle compared to those who tested negative at screening. Citation Format: Paula Berstad, Magnus Løberg, Inger Kristin Larsen, Mette Kalager, Øyvind Holme, Michael Bretthauer, Geir Hoff. Colorectal cancer screening and long-term lifestyle changes: A randomized controlled trial. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr C04.

Continuous quality improvement of colorectal cancer screening

Quality assurance is a key issue in colorectal cancer screening, because effective screening is able to improve primary prevention of the cancer. The quality measure may be described in terms: how well the screening test tells who truly has a disease (sensitivity) and who truly does not have a disease (specificity). This paper raises concerns about identification of the optimal screening test for colorectal cancer. Colonoscopy vs flexible sigmoidoscopy in colorectal cancer screening has been a source of ongoing debate. A multicentre randomised controlled trial comparing flexible sigmoidoscopy with usual care showed that flexible sigmoidoscopy screening is able to diminish the incidence of distal and proximal colorectal cancer, and also mortality related to the distal colorectal cancer. However, colonoscopy provides a more complete examination and remains the more sensitive exam than flexible sigmoidoscopy. Moreover, colonoscopy with polypectomy significantly reduces colorectal cancer incidence and colorectal cancer-related mortality in the general population. The article considers the relative merits of both methods and stresses an ethical aspect of patient's involvement in decision-making. Patients should be informed not only about tests tolerability and risk of endoscopy complications, but also that different screening tests for bowel cancer have different strength to exclude colonic cancer and polyps. The authorities calculate effectiveness and costs of the screening tests, but patients may not be interested in statistics regarding flexible sigmoidoscopy screening and from an ethical point of view, they have the right to chose colonoscopy, which is able to exclude a cancer and precancerous lesions in the whole large bowel.

Patient-reported outcomes following flexible sigmoidoscopy screening for colorectal cancer in a demonstration screening programme in the UK

Flexible sigmoidoscopy (FS) screening for colorectal cancer will be introduced into the National Cancer Screening Programmes in England in 2013. Patient-reported outcome measures (PROMs) from trial participants indicate high acceptability and no adverse physical or psychological consequences, but this may not generalize to routine screening in the community. This study examined PROMs in a community-based FS screening programme. Eligible adults aged 58-59 (n = 2016) registered at 34 London general practices were mailed a National Health Service-endorsed invitation to attend FS screening. Pain and side-effects were assessed in a 'morning-after' questionnaire, and satisfaction was assessed in a three-month follow-up questionnaire. Anxiety, self-rated health and colorectal symptoms were assessed at prescreening and follow-up. In total, 1020 people attended screening and were included in the current analyses, of whom 913 (90%) returned the morning-after questionnaire, and 674 (66%) the follow-up questionnaire. The prescreening questionnaire had been completed by 751 (74%) of those who attended. The majority (87%) of respondents reported no pain or mild pain, and the most frequent side-effect (wind) was only experienced more than mildly by 16%. Satisfaction was extremely high, with 98% glad they had the test; 97% would encourage a friend to have it. From prescreening to follow-up there were no changes in anxiety or self-rated health, and the number of colorectal symptoms declined. Satisfaction and changes in wellbeing were not moderated by gender, deprivation, ethnicity or screening outcome. PROMs indicate high acceptability of FS screening in 58-59 year olds, with no adverse effects on colorectal symptoms, health status or psychological wellbeing.

Patient-Reported Outcomes Following Flexible Sigmoidoscopy Screening for Colorectal Cancer in a Demonstration Screening Programme in the Uk

Objectives Flexible sigmoidoscopy (FS) screening for colorectal cancer will be introduced into the National Cancer Screening Programmes in England in 2013. Patient-reported outcome measures (PROMs) from trial participants indicate high acceptability and no adverse physical or psychological consequences, but this may not generalize to routine screening in the community. This study examined PROMs in a community-based FS screening programme. Methods Eligible adults aged 58–59 ( n = 2016) registered at 34 London general practices were mailed a National Health Service-endorsed invitation to attend FS screening. Pain and side-effects were assessed in a ‘morning-after’ questionnaire, and satisfaction was assessed in a three-month follow-up questionnaire. Anxiety, self-rated health and colorectal symptoms were assessed at prescreening and follow-up. Results In total, 1020 people attended screening and were included in the current analyses, of whom 913 (90%) returned the morning-after questionnaire, and 674 (66%) the follow-up questionnaire. The prescreening questionnaire had been completed by 751 (74%) of those who attended. The majority (87%) of respondents reported no pain or mild pain, and the most frequent side-effect (wind) was only experienced more than mildly by 16%. Satisfaction was extremely high, with 98% glad they had the test; 97% would encourage a friend to have it. From prescreening to follow-up there were no changes in anxiety or self-rated health, and the number of colorectal symptoms declined. Satisfaction and changes in wellbeing were not moderated by gender, deprivation, ethnicity or screening outcome. Conclusions PROMs indicate high acceptability of FS screening in 58–59 year olds, with no adverse effects on colorectal symptoms, health status or psychological wellbeing.

Flexible sigmoidoscopy screening reduced colorectal cancer incidence and mortality in older adults

ACP Journal Club18 September 2012Flexible sigmoidoscopy screening reduced colorectal cancer incidence and mortality in older adultsCharles J. Kahi, MD, MSc, FACP, FACG, AGAF, Thomas F. Imperiale, MD, FACP, AGAFCharles J. Kahi, MD, MSc, FACP, FACG, AGAFIndiana University; Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA (C.J.K., T.F.I.)Search for more papers by this author, Thomas F. Imperiale, MD, FACP, AGAFIndiana University; Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA (C.J.K., T.F.I.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-6-201209180-02003 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationSchoen RE, Pinsky PF, Weissfeld JL, et al; PLCO Project Team. Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med. 2012;366:2345-57. https://pubmed.ncbi.nlm.nih.gov/22612596Clinical Impact RatingsGIM/FP/GP: Gastroenterology: References1 Atkin WS, Edwards R, Kralj-Hans I, et al; UK Flexible Sigmoidoscopy Trial Investigators. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375:1624-33. [PMID: 20430429] Google Scholar2 Segnan N, Armaroli P, Bonelli L, et al; SCORE Working Group. Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial—SCORE. J Natl Cancer Inst. 2011;103:1310-22. [PMID: 21852264] Google Scholar3 Baxter NN, Sutradhar R, Forbes SS, et al. Analysis of administrative data finds endoscopist quality measures associated with postcolonoscopy colorectal cancer. Gastroenterology. 2011;140:65-72. [PMID: 20854818] Google Scholar Author, Article, and Disclosure InformationAuthors: Charles J. Kahi, MD, MSc, FACP, FACG, AGAF; Thomas F. Imperiale, MD, FACP, AGAFAffiliations: Indiana University; Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA (C.J.K., T.F.I.)This article was published at Annals.org on 4 September 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEvaluation of Blood Stool Test Utilization for Colorectal Cancer Screening in Georgia, USABetween-ward disparities in colorectal cancer incidence and screening in Washington DCClinical Decision Support With Natural Language Processing Facilitates Determination of Colonoscopy Surveillance IntervalsNatural Language Processing Accurately Categorizes Findings From Colonoscopy and Pathology Reports 18 September 2012Volume 157, Issue 6Page: JC3-3KeywordsCancer screeningCancer treatmentColonoscopyColorectal cancerElderlyFlexible sigmoidoscopyLung and intrathoracic tumorsMortalityOvarian cancerSmall cell lung cancer ePublished: 18 September 2012 Issue Published: 18 September 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

PWE-199 Quality of flexible sigmoidoscopy for colorectal cancer screening: are we there yet?

IntroductionColorectal cancer (CRC) screening with flexible sigmoidoscopy (FS) has been associated with reduced incidence and mortality from CRC. The NHS in UK is introducing FS screening for all men and...