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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 5/2015

01-05-2015 | Editorial

Detection of Advanced Neoplasia with FIT Versus Flexible Sigmoidoscopy Versus Colonoscopy: More Is More

Authors: Robert E. Schoen, Jorge D. Machicado

Published in: Digestive Diseases and Sciences | Issue 5/2015

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Excerpt

Flexible sigmoidoscopy visualizes the rectum and the sigmoid colon and, at times, the descending colon and even the splenic flexure. Unlike colonoscopy, it does not permit inspection of the entire transverse and the right colon. As a result, the efficacy of flexible sigmoidoscopy in preventing colorectal cancer in the proximal colon is dependent on identifying abnormalities in the distal colon, which will predict neoplasia in the proximal colon. Individuals with a negative flexible sigmoidoscopy do not go on to colonoscopy, so subjects with isolated proximal neoplasia are not detected and flexible sigmoidoscopy cannot prevent colorectal cancer in that circumstance. …
Literature
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Atkin WS, Edwards R, Kralj-Hans I, et al. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375:1624–1633.CrossRefPubMed
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Segnan N, Armaroli P, Bonelli L, et al. Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial—SCORE. J Natl Cancer Inst. 2011;103:1310–1322.CrossRefPubMed
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Holme O, Loberg M, Kalager M, et al. Effect of flexible sigmoidoscopy screening on colorectal cancer incidence and mortality: a randomized clinical trial. [Erratum appears in JAMA. 2014 Sep 3;312(9):964]. JAMA 2014;312:606–615.
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Castro I, Estevez P, Cubiella J, et al. Diagnostic performance of fecal immunochemical test and sigmoidoscopy for advanced right-sided colorectal neoplasms. Dig Dis Sci. (Epub ahead of print). doi:10.​1007/​s10620-014-3434-6.
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Chiang T-H, Chuang S-L, Chen SL-S, et al. Difference in performance of fecal immunochemical tests with the same hemoglobin cutoff concentration in a nationwide colorectal cancer screening program. Gastroenterology. 2014;147:1317–1326.CrossRefPubMed
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Schoen RE, Pinsky PF, Weissfeld JL, et al. Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med. 2012;366:2345–2357.CrossRefPubMedCentralPubMed
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Metadata
Title
Detection of Advanced Neoplasia with FIT Versus Flexible Sigmoidoscopy Versus Colonoscopy: More Is More
Authors
Robert E. Schoen
Jorge D. Machicado
Publication date
01-05-2015
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 5/2015
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-015-3583-2

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Keynote webinar | Spotlight on medication adherence

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