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Sigmoidoscopy Cuts Risk of Colon Cancer Death: Study

But experts note most Americans get colonoscopies instead

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Colon cancer screening done by sigmoidoscopy -- a less invasive, cheaper alternative to colonoscopy -- does cut people's risk of developing or dying from the disease, a new clinical trial finds.

Experts said the study, conducted in Norway and reported in the Aug. 13 issue of the Journal of the American Medical Association, confirms the value of sigmoidoscopy screening.

But in the United States, where few doctors even perform sigmoidoscopy, the results are unlikely to make a difference in everyday practice.

"Sigmoidoscopy is definitely second-best to colonoscopy," said Dr. James Church, a colorectal surgeon at the Cleveland Clinic in Ohio.

That's mainly because sigmoidoscopy looks only at the lower portion -- or "left side" -- of the colon, said Church, who was not involved in the study. Colonoscopy gives doctors a view of the entire colon.

Both procedures not only detect cancer but also help prevent it -- by allowing doctors to remove potentially precancerous growths called polyps. But colonoscopy can pick up polyps throughout the colon.

"Colonoscopy is not perfect, by any means," Church said. But, he added, "if you don't want to get colon cancer, colonoscopy is the best option."

The new trial was conducted in Norway, where there is no routine colon cancer screening, explained lead researcher Dr. Oyvind Holme, of Sorlandet Hospital in Kristiansand, Norway.

That allowed the researchers to offer one-time sigmoidoscopy screening to over 20,000 50- to 64-year-old adults, then compare them with 78,000 people the same age who were not offered any kind of colon cancer screening.

Half of the sigmoidoscopy group also received a stool test to look for hidden blood -- another option for colon cancer screening.

Holme's team found that people who underwent screening were 27 percent less likely to die of colon cancer over the next decade, versus the unscreened group.

According to Holme, the findings bolster evidence that sigmoidoscopy is a "valuable tool" for colon cancer screening.

But, he said, they don't mean that sigmoidoscopy is the best tool. "We did not compare flexible sigmoidoscopy to other screening methods," Holme pointed out.

In the United States, experts advise most people to begin colon cancer screening at age 50.

The U.S. Preventive Services Task Force recommends three choices: an annual stool test; sigmoidoscopy every five years, along with stool testing every three years; or colonoscopy every 10 years.

In practice, though, colonoscopy is by far the most common test in the United States.

Sigmoidoscopy does have a number of advantages over colonoscopy, Holme said. The pre-exam bowel cleanse is easier to take, and the procedure itself is faster, does not require sedation and can be done by a primary care doctor or trained nurse -- whereas colonoscopies are done by gastroenterologists.

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