title: Is There a Place for Screening Flexible Sigmoidoscopy?
abstract: Flexible sigmoidoscopy is a valid screening tool for the early detection of colorectal cancer (CRC). Recently published long-term data from UKFSST, a randomized controlled trial, demonstrate a 33% reduction in colorectal cancer incidence and a 43% decrease in colorectal cancer mortality, with once-in-a-lifetime screening. On the other hand, data from the NORCCAP trial with a similar protocol show no reduction in CRC incidence and only nonsignificant decrease in CRC mortality at 7 years. At best, flexible sigmoidoscopy can detect only 70% of cancers and polyps as it does not detect the 40% of proximal neoplasms which are not associated with a distal lesion. The advantage of flexible sigmoidoscopy over other screening modalities lies in its safety profile, patient tolerance, and overall acceptance. Its technical simplicity, short duration, and cost-effectiveness advance its applicability to mass screening programs.
authors.affiliation: Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, 39 Jabotinski Street, Petach Tikva 49100, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Boltin
authors.forename: Yaron
authors.initials: Y
authors.lastname: Niv