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Long-Term Effectiveness of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality in Women and Men: A
Øyvind Holme1, Magnus Løberg1, Mette Kalager2
1Sørlandet Hospital Kristiansand, Kristiansand, Norway, and University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway (Ø.H., M.L., M.B., T.J.E.).
Annals of Internal Medicine
|May 1, 2018
Summary
Flexible sigmoidoscopy screening significantly reduced colorectal cancer (CRC) incidence and mortality in men. However, the screening showed minimal impact on CRC rates for women after 15 years.
Area of Science:
- Gastroenterology
- Preventive Medicine
- Oncology
Background:
- Long-term effects of sigmoidoscopy screening for colorectal cancer (CRC) remain unclear.
- Previous studies have not definitively established CRC screening effectiveness in diverse populations.
Purpose of the Study:
- To evaluate the 15-year effectiveness of flexible sigmoidoscopy screening.
- To assess screening impact on colorectal cancer incidence and mortality in men and women.
Main Methods:
- A randomized controlled trial involving 98,678 participants aged 50-64.
- Flexible sigmoidoscopy screening (with or without fecal blood testing) versus no screening.
- Follow-up via national registries for CRC incidence and mortality data.
Main Results:
- Sigmoidoscopy screening reduced CRC incidence (HR: 0.66) and mortality (HR: 0.63) in men.
- Screening showed no significant reduction in CRC incidence (HR: 0.92) or mortality (HR: 1.01) in women.
- Absolute risk reduction for CRC in men was 0.78 percentage points.
Conclusions:
- Flexible sigmoidoscopy screening is effective in reducing colorectal cancer burden in men.
- Screening demonstrated limited benefit for colorectal cancer prevention in women.
- Sex-specific differences in screening effectiveness warrant further investigation.
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