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What Colon Cancer Test Is Best for Women?

Colonoscopy Identifies More Cancers in Women, Researchers Say
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Schoenfeld and colleagues studied more than 1,400 women aged 50-79. The women had an "average risk" of colorectal cancer, says the study. A total of 230 women (about 16%) had a family history of colon cancer.

The women filled out detailed questionnaires about risk factors before undergoing colonoscopy.

While everyone is at risk for colon cancer, traditional risk factors for colon cancer include:

  • Age. Risk increases with age.
  • Sex. Women are at a higher risk for colon cancer while men have a higher risk for cancer of the rectum.
  • Family history. Parents, siblings, and children of a person who has had colorectal cancer are somewhat more likely to develop colorectal cancer themselves.
  • Diet. Diets high in fat and calories and low in fiber are linked to this cancer.
  • Polyps. These noncancerous growths are common in people over the age of 50. A certain type of polyp, called adenomas, is considered precancerous.

The researchers estimated the number of cancers, polyps, and other problems that would have gone undetected if the women had only gotten sigmoidoscopy.

Colonoscopy identified cancers and polyps in 72 women (5%). Only 35% of those women would have had those lesions identified if they had only gotten sigmoidoscopy, says the study.

Outcome in Men

Researchers had previously done a similar estimate on men. That study affirmed colonoscopy's superiority.

However, the men's study showed that sigmoidoscopy would have identified cancer and polyps in a greater percentage of affected participants (66%), say Schoenfeld and colleagues.

"We found that almost twice as many cases of advanced colorectal neoplasia were detected in the men," write the researchers. "Flexible sigmoidoscopy appears to be a much more effective screening tool in men than women."

'Preferred' Screening Method for Women

"On the basis of these data, we believe that colonoscopy is the preferred method of screening for colorectal cancer in women, and that flexible sigmoidoscopy is an inadequate method of predicting advanced neoplasia in the proximal colon in women," write researchers.

The men's results came from the Veterans Affairs Cooperative Study 380. The women's study included women from four military medical centers.

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