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Screening for colorectal cancer

J Austoker1

  • 1Department of Public Health and Primary Care, University of Oxford.

BMJ (Clinical Research Ed.)
|August 6, 1994
PubMed
Summary

Flexible sigmoidoscopy screening for colorectal cancer may prevent thousands of cases and deaths annually in the UK. Further randomized trials are prioritized to confirm these findings for early cancer detection.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Preventive Medicine

Background:

  • Colorectal cancer is a leading cause of cancer death in the UK, with nearly 20,000 deaths annually.
  • Current screening methods like faecal occult blood tests have limitations in sensitivity and population uptake.
  • Early detection and treatment are crucial for reducing colorectal cancer mortality.

Purpose of the Study:

  • To evaluate the potential effectiveness of flexible sigmoidoscopy in reducing colorectal cancer mortality.
  • To compare flexible sigmoidoscopy with faecal occult blood tests for cancer screening.
  • To determine the need for routine screening in asymptomatic populations.

Main Methods:

  • Review of current evidence on colorectal cancer screening efficacy.
  • Analysis of potential benefits of detecting and removing premalignant adenomas via flexible sigmoidoscopy.
  • Estimation of potential impact of flexible sigmoidoscopy screening on cancer incidence and mortality.

Main Results:

  • Faecal occult blood tests demonstrate low sensitivity and moderate population uptake.
  • Flexible sigmoidoscopy, including surveillance, could potentially prevent 5500 cancer cases and 3500 deaths annually in the UK.
  • Screening around age 60 with flexible sigmoidoscopy may be more effective than current methods.

Conclusions:

  • Routine faecal occult blood testing for asymptomatic individuals is not yet justified.
  • Flexible sigmoidoscopy shows promise as a more effective screening tool for reducing colorectal cancer deaths.
  • A randomized controlled trial for flexible sigmoidoscopy screening is a priority.

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