HEALTHScreening interval for colorectal cancer debatedBut experts stress that the need to increase the overall number of patients tested should be incorporated as part of a preventive health care strategy.By Susan J. Landers, amednews staff. May 5, 2003. Washington -- A new study suggests that increasing the number of years between screenings for colorectal cancer via sigmoidoscopy could still provide patients a high level of protection from potentially lethal polyps. However, both the American Cancer Society and the American Gastroenterological Assn. have decided the appropriate interval between sigmoidoscopy screenings is five years, and there it will likely stay for the next few years at least. The study in the April 16 issue of the Journal of the National Cancer Institute found that screening sigmoidoscopy was effective in reducing the incidence of distal colorectal cancer and that the reduction was sustained for more than 15 years. In the population-based, case-controlled study, researchers collected data on screening history and risk factors from 1,026 patients with distal colorectal cancer, 642 patients with proximal colorectal cancer and 1,294 control subjects. They found that individuals who had a screening sigmoidoscopy had a fourfold reduction in the incidence of distal colorectal cancer, compared with individuals who had never had a screening sigmoidoscopy. The researchers from the Fred Hutchinson Cancer Center in Seattle concluded that the recommended five-year interval might be unnecessarily aggressive. That may be true, some experts note, but this is not the study that proves it. "A more precise estimate of the benefit from sigmoidoscopy screening will have to await the results from the ongoing [randomized controlled trials]," wrote Jack S. Mandel, PhD, MPH, chair of the department of epidemiology at Atlanta's Emory University, in an accompanying editorial. "At that time, we will be in a better position to more accurately evaluate the risks, benefits and cost effectiveness of screening." [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2003 American Medical Association. All rights reserved.
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