Once-Only Flexible Sigmoidoscopy for Colon Cancer Mortality Reduction

MedicalResearch.com Interview with:
Øyvind Holme, MD
Department of Medicine, Sorlandet Hospital Kristiansand, Kristiansand, Norway
Institute of Health and Society, University of Oslo, Oslo, Norway
Departments of Epidemiology and Biostatistics, Harvard School of Public Health,
Harvard-MIT Division of Health Sciences and Technology
Boston, Massachusetts
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway

Medical Research: What are the main findings of the study?

Dr. Holme: In this population-based trial, we found that once-only flexible sigmoidoscopy screening in asymptomatic 50-64 year old individuals reduces colorectal cancer mortality by 27% and colorectal cancer incidence by 20% after 11 years of follow-up. We found that the incidence reduction is as great in 50-54 year old individuals as in 55-64 old individuals. Addition of a once-only fecal occult blood test to flexible sigmoidoscopy did not lead to a larger reduction in colorectal cancer incidence or mortality compared to flexible sigmoidoscopy screening alone.

Medical Research: Were any of the findings unexpected?

Dr. Holme: Our results confirm the results from previous randomized trials of flexible sigmoidoscopy screening and was not unexpected. The strength of the trial lies in the population-based design, the inclusion of the 50-54 year old age-group and the absence of concurrent screening for colorectal cancer in the screening areas throughout the follow-up period.

Medical Research: What should clinicians and patients take away from your report?

Dr. Holme: Flexible sigmoidoscopy is a valuable tool in colorectal cancer screening. It reduces both incidence and mortality from colorectal cancer.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Holme: Today, several colorectal cancer screening tests are offered to the public, but we are not sure which test is the best. Head-to-head comparisons of different screening modalities are warranted.

Citation:

Holme Ø, Løberg M, Kalager M, et al. Effect of Flexible Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality: A Randomized Clinical Trial. JAMA. 2014;312(6):606-615. doi:10.1001/jama.2014.8266.