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Single Screening Cuts Colon Cancer Risk

Flexible Sigmoidoscopy Prevents Cancer, Reduces Need for Colonoscopy

Implications for U.S. Colon Cancer Screening

What about the U.S., where the gold standard is colonoscopy every 10 years beginning at age 50?

Insight comes from John Monson, MD, chief of colorectal surgery at the University of Rochester, N.Y. Monson helped design the U.K. national training program that teaches nurses to perform sigmoidoscopies, and he also assisted in the design of the Atkin study (although he was not involved in the study itself).

"If you are fortunate enough to have insurance, assuming you are age 50 or so, then a colonoscopy is the right thing. But the reality is that large numbers of American patients do not have access to colonoscopy," Monson tells WebMD.

We shouldn't think of sigmoidoscopy as replacing colonoscopy, Monson says. Instead, we should think of it as a way to look for patients who truly need a colonoscopy.

"Flexible sigmoidoscopy is actually a very good use of health care resources to screen for people who should have a colonoscopy, which does have its downsides due to complications and costs," he says. "It is not simply flexible sigmoidoscopy, period. It is sigmoidoscopy followed by colonoscopy if you have certain findings. And it is pretty effective at preventing colon cancer."

The Atkin study appears in the April 28 online edition of The Lancet.

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