Long-Term Risk- Reduction Benefits of Sigmoidoscopy and Colonoscopy
December 1, 2013 less than 1 minute read
Participants from two large observational studies provide an opportunity to evaluate the risk reduction accrued from either colonoscopy (COL) or sigmoidoscopy (SIG). The Nurses’ Health Study (n = 121,700 female nurses) and the Health Professionals Follow-up Study (n = 51,529 male health professionals) have more than 20 years’ prospective follow-up of their participants. During this interval, there were 1185 cases of colon cancer and 474 deaths from colon cancer.
Skeptics have long held fast to the tenet that SIG had an advantage over COL: proven risk reduction for colon cancer mortality for the former. Although the intuitive additional advantage of examining the entire colon with COL seemed a no-brainer, purists argued that whether COL was truly better than SIG was not yet proven, and that since COL was associated with greater risks (perforation, adverse effects from sedation, etc.), there was reasonable basis to continue with SIG as a preferred method. In accord with this philosophy, noting the many missed opportunities for colon cancer screening and prevention, advocacy groups rallied around the call-to-action, “The best colon cancer screening test is whichever one you can get done!”
These data may change that perspective, since the risk reduction for colon cancer death was almost twice as great for COL as SIG (hazard ratios, 0.59 vs 0.32). The “no-brainer” part of the equation was also resoundingly confirmed: COL reduced mortality from proximal colon cancer by more than half compared to no risk reduction through SIG.
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