title: Long-term efficacy of sigmoidoscopy in the reduction of colorectal cancer incidence.
abstract: Screening sigmoidoscopy is associated with a reduction in both the incidence and mortality of colorectal cancer. Although current guidelines recommend sigmoidoscopy screening every 5 years, the duration of risk reduction is not known. We conducted a population-based case-control study to examine the association between sigmoidoscopy screening and colorectal cancer incidence. We collected information on screening history and risk factors from case patients with distal (n = 1026) and proximal (n = 642) colorectal cancer and from 1294 control subjects from October 1998 through February 2002. Screening sigmoidoscopy was associated with a statistically significant reduction in the incidence of distal colorectal cancer (odds ratio [OR] = 0.24, 95% confidence interval [CI] = 0.17 to 0.33). These reductions were sustained for up to 16 years with little attenuation. We also observed strong inverse associations between cancer incidence and sigmoidoscopy in analyses that included subjects with symptom-related tests. Current recommendations regarding the frequency of sigmoidoscopy screening may be unnecessarily aggressive.
authors.affiliation: Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle 98109-1024, USA. pnewcomb@fhcrc.org
authors.forename: Polly A
authors.initials: PA
authors.lastname: Newcomb
authors.forename: Barry E
authors.initials: BE
authors.lastname: Storer
authors.forename: Libby M
authors.initials: LM
authors.lastname: Morimoto
authors.forename: Allyson
authors.initials: A
authors.lastname: Templeton
authors.forename: John D
authors.initials: JD
authors.lastname: Potter
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D016017:Odds Ratio; D012812:Sigmoidoscopy; D013997:Time Factors; D014861:Washington / Q000453:epidemiology