Colorectal cancer screening: Flexible sigmoidoscopy expert panel 2nd supplement to 2nd watching brief (2012)

May 23, 2012

Review the PLCO trial results about flexible sigmoidoscopy for colorectal cancer screening in this 2012 second supplement

This document provides results from the fourth international flexible sigmoidoscopy trial (the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial) about long-term death rates with screening.

This is the second supplement to the second watching brief on flexible sigmoidoscopy. This supplement can be used by provincial cancer agencies to put the trial results in context with the number of deaths from the other three international flexible sigmoidoscopy trials. After the release of this document, a comprehensive watching brief that incorporates all flexible sigmoidoscopy randomized trial outcomes will be distributed.

The published results from the US, UK, Italy and Norway trials provide clear evidence that screening with flexible sigmoidoscopy reduces both colorectal cancer deaths and rates of colorectal cancer in average-risk individuals.

The PLCO study reported a significant reduction of 26 per cent and 21 per cent in colorectal deaths and rates, respectively, in the screening arm for average-risk individuals aged 55 to 74 years. Three trial results show a statistically significant reduction in colorectal cancer rates and two of the trials found statistically significant reductions in colorectal cancer deaths.

Flexible sigmoidoscopy for colorectal cancer screening needs to be considered as an option in organized screening programs in Canada. Fecal occult blood testing is already used as the main program screening test.

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