Fifteen-Year Benefits of Screening Sigmoidoscopy, Based on Pooled Results of 4 Randomized Controlled Trials
Douglas K. Rex, MD, MASGE, reviewing Juul FE, et al. Ann Intern Med 2022 Oct 11.
This is a pooled analysis of 4 randomized controlled trials of one-time sigmoidoscopy screening in patients aged 55 to 64 years. The trials were conducted in Norway, the U.S., the U.K., and Italy.
The percentage of patients who attended screening ranged from 58% to 84%. Incidence and mortality were reported on an intent-to-treat (intent-to-screen) basis. Among 274,952 persons, the overall incidence reduction in colorectal cancer (CRC) was 21%, which was accounted for almost entirely by a reduction in distal cancer. The decrease in CRC incidence in men and women in the screening group versus those in the usual-care group was 25% in men and 16% in women. The CRC mortality reduction was 20% overall, including 27% in men and a 9% reduction in women that did not reach significance.
There was also an all-cause mortality reduction of 2% that reached statistical significance.
COMMENTThe study shows an overall incidence reduction and mortality reduction of about 20% each from CRC with the use of screening sigmoidoscopy on an intent-to-screen basis. The all-cause mortality reduction is also important and rarely seen with an organ screening test. As with other screening tests, persons who actually undergo the test have a greater chance of avoiding CRC incidence and death.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Juul FE, Cross AJ, Schoen RE, et al. 15-year benefits of sigmoidoscopy screening on colorectal cancer incidence and mortality: a pooled analysis of randomized trials. Ann Intern Med 2022 Oct 11. (Epub ahead of print) (https://doi.org/10.7326/m22-0835)
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