Colorectal cancer screening: Flexible sigmoidoscopy expert panel (2012)

September 19, 2012

Review the September 2012 synthesized results about flexible sigmoidoscopy for colorectal cancer screening from four randomized controlled trials

Flexible sigmoidoscopy is an endoscopic procedure which uses a flexible fiber-optic instrument to examine the rectum and lower (distal) colon. Colonoscopy examines the rectum and total (upper and lower) colon.

The results from the US PLCO, the UK FS, the Italy (SCORE), and the Norwegian (NORCCAP) trials give clear evidence that screening with flexible sigmoidoscopy reduces the rate of colorectal cancer and the number of related deaths in average-risk individuals.

The PLCO trial reported a reduction of 26 per cent in colorectal cancer deaths and a reduction of 21 per cent in the rate of colorectal cancer in the screening arm for average-risk individuals aged 55 to 74 years. The results of three trials show a statistically significant reduction in the rate of colorectal cancer. Two trials show statistically significant reductions in deaths from colorectal cancer. Flexible sigmoidoscopy could be a considered as a component of organized colorectal cancer screening programs in Canada.

 The results of each trial were highlighted in its own watching brief or watching brief supplement. Two watching briefs and two watching brief supplements have been published:

• June 2009 – Watching brief 1 focuses on the NORCCAP trial results.
• June 2010 – Watching brief 2 focuses on the UK FS trial results.
• October 2011 – Supplement to watching brief 2 focuses on the SCORE trial results.
• May 2012 – Second supplement to watching brief 2 focuses on the PLCO trial results.

Downloadable content