Effect of Flexible Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality

• DOI: 10.1001/jama.2014.8266
• Publication Date: 2014-08-12T22:31:42Z
• Authors: Øyvind Holme; Magnus Løberg; Mette Kalager; Michael Bretthauer; Miguel A. Hernán; Eline Aas; Tor J. Eide; Eva Skovlund; Jørn Schneede; Kjell Magne Tveit; Geir Hoff
• Keywords: Sigmoidoscopy; Fecal occult blood

Colorectal cancer is a major health burden. Screening recommended in many countries.To estimate the effectiveness of flexible sigmoidoscopy screening on colorectal incidence and mortality population-based trial.Randomized clinical trial 100,210 individuals aged 50 to 64 years, identified from population Oslo city Telemark County, Norway. was performed 1999-2000 (55-64-year age group) 2001 (50-54-year group), with follow-up ending December 31, 2011. Of those selected, 1415 were excluded due prior cancer, emigration, or death, 3 could not be traced registry.Participants randomized group invited undergo screening. Within group, participants 1:1 receive once-only combination fecal occult blood testing (FOBT). Participants positive test results (cancer, adenoma, polyp ≥10 mm, FOBT) offered colonoscopy. The control received no intervention.Colorectal mortality.A total 98,792 included intention-to-screen analyses, whom 78,220 comprised 20,572 (10,283 10,289 FOBT). Adherence 63%. After median 10.9 71 died vs 330 (31.4 43.1 deaths per 100,000 person-years; absolute rate difference, 11.7 [95% CI, 3.0-20.4]; hazard ratio [HR], 0.73 0.56-0.94]). diagnosed 253 1086 (112.6 141.0 cases 28.4 12.1-44.7]; HR, 0.80 0.70-0.92]). reduced both 50- 54-year (HR, 0.68; 95% 0.49-0.94) 55- 64-year 0.83; 0.71-0.96). There difference between only FOBT groups.In Norway, level compared effective groups.clinicaltrials.gov Identifier: NCT00119912.