Colorectal Cancer Tests Are Not Created Equal
Lieberman says that FOBT and sigmoidoscopy, while not perfect, have a place in colorectal cancer screening. Many health organizations still recommend annual fecal occult testing, as well as a sigmoidoscopy every five years or a colonoscopy every 10 years for those 50 and over.
"This research shows that physicians can't really sit down with patients who have had a single FOBT and sigmoidoscopy and tell them they have nothing to worry about, because a quarter of those patients could still have something serious that hasn't been spotted," Lieberman says. "With colonoscopy they can offer patients that reassurance, assuming the exam is done correctly."
National Colorectal Cancer Research Alliance spokesperson Steve Telliano says his organization does not recommend the routine use of sigmoidoscopy for colorectal cancer screening, but strongly supports the combination of annual FOBT and a colonoscopy every 10 years in people who are 50 and over. Those with a family history of colorectal cancer and those with other risk factors for the disease probably require earlier and more frequent screenings, he added.
Anil K. Rustgi, MD, chief of gastroenterology at the University of Pennsylvania, says there has been a heightened awareness in recent years about the value of colorectal cancer screening. High profile celebrities like Katie Couric, who lost her husband to colon cancer, have helped draw attention to the subject. But Rustgi adds that too many people still avoid the tests and too few doctors recommend them.
"Up until a couple of decades ago, women were reticent about being screened for breast cancer," Rustgi tells WebMD. "We are seeing some of that with colon cancer. People who are not educated about screening are often apprehensive about it. But there has been a shift in attitude, and I believe the compliance with screening recommendations will increase annually going forward."