Repeat Flexible Sigmoidoscopy Increases Detection of CRC

Rescreening increases yield of colorectal cancer or advanced adenomas by 32 percent

WEDNESDAY, Feb. 1 (HealthDay News) -- Repeated screening by flexible sigmoidoscopy (FSG) increases the detection of colorectal cancer or advanced adenoma in women and men, according to a study published online Jan. 31 in the Journal of the National Cancer Institute.

Joel L. Weissfeld, M.D., M.P.H., of the University of Pittsburgh Cancer Institute, and colleagues reported outcomes from participants of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial who were randomly assigned to receive FSG. Patients were screened by 60-cm FSG at study entry and three or five years later. Results from subsequent diagnostic intervention were recorded and outcomes were compared based on gender and age.

The researchers found that, of 77,447 enrollees, 86.6 percent had at least one FSG and 50.9 percent had two FSGs. Diagnostic intervention occurred in 74.9 and 78.7 percent of patients after a positive first or repeat FSG, respectively. The screening yield increased by 32 percent based on the second FSG. After the first screening, colorectal cancer or advanced adenoma was detected in 37.8 per 1,000 persons, and after all screenings, in 49.8 per 1,000 persons. The yield of cancer or advanced adenoma was increased by the second FSG by 26 percent in women and by 34 percent in men. Of 223 subjects who received a diagnosis of colorectal carcinoma within one year of a positive FSG, stage I and II disease were seen in 64.6 and 17.5 percent, respectively.

"Repeat FSG increased the detection of colorectal cancer or advanced adenoma in women by one-fourth and in men by one-third," the authors write.

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