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Flexible sigmoidoscopy as a mass screening tool

W S Atkin1

  • 1ICRF Colorectal Cancer Unit, St Mark's Hospital, Northwick Park, Harrow, Middlesex, UK.

European Journal of Gastroenterology & Hepatology
|May 19, 1998
PubMed
Summary

Screening for colorectal cancer using flexible sigmoidoscopy (FS) is a cost-effective strategy. However, more data is needed on the precise reduction in mortality and associated costs before widespread implementation.

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Area of Science:

  • Gastroenterology
  • Preventive Medicine
  • Public Health

Background:

  • Colorectal cancer (CRC) screening aims to reduce mortality rates.
  • Current US guidelines advocate for endoscopic removal of adenomas, while the UK favors flexible sigmoidoscopy (FS).
  • FS is considered more cost-effective than colonoscopy but remains invasive and carries risks.

Purpose of the Study:

  • To evaluate the precise reduction in colorectal cancer mortality rates.
  • To estimate the financial, physical, and emotional costs associated with screening.
  • To inform decisions regarding the implementation of mass CRC screening programs.

Main Methods:

  • Review of existing randomized trials, including a large British study.
  • Analysis of cost-effectiveness of flexible sigmoidoscopy.

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  • Assessment of potential harms and benefits of screening procedures.

    • Main Results:

    • Flexible sigmoidoscopy (FS) is a more cost-effective screening option compared to colonoscopy.
    • While FS is more acceptable, it is an invasive procedure with a small risk of serious harm.
    • Precise estimates of mortality reduction and comprehensive cost analyses are still under evaluation.

    Conclusions:

    • Further research is necessary to determine the optimal strategy for colorectal cancer screening.
    • Balancing the benefits of reduced mortality against the costs and risks of screening is crucial.
    • Ongoing randomized trials are expected to provide critical data for public health policy decisions.