Colorectal cancer screening: Flexible sigmoidoscopy expert panel 2nd watching brief (2010)

Review the UK FS trial results about flexible sigmoidoscopy for colorectal cancer screening in this watching brief from June 2010

This watching brief gives background information and, when they become available, puts trial results in perspective about the benefits and adverse effects of flexible sigmoidoscopy for colorectal cancer screening. This brief also discusses the quality and limitations of the evidence.

Health policy advisors involved in cancer control can use this brief’s information to respond to the results of the ongoing trials as they are published. This watching brief gives background information, but no definitive answers or clinical recommendations.

The UK FS trial provides the strongest evidence to date that using flexible sigmoidoscopy for screening results in a 31 per cent reduction in colorectal cancer deaths and a 23 per cent reduction in the rate of colorectal cancer.

Both FOBT- and FS-based screening are now supported by the strongest level of evidence from randomized controlled trials. However, the UK FS trial observed greater reductions in the rates of colorectal cancer and the number of deaths than those reported in the randomized controlled trials that evaluated unrehydrated fecal occult blood tests (FOBT). With the UK FS trial’s significant results available, the role of flexible sigmoidoscopy in organized colorectal cancer screening programs will need to be examined.

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