Editorial: Why You Should Care about Screening Flexible Sigmoidoscopy — NEJM

Blogger's Note: read the whole editorial for further information regarding colonoscopies, this blog also has trial data on colonoscopies/research/opinions

Why You Should Care about Screening Flexible Sigmoidoscopy — NEJM

"...The real question for U.S. (blogger's note: and others)  clinicians is whether we are prepared to refocus attention on a screening strategy that has been likened to performing mammography on one breast..."

...Where does this leave us with regard to screening flexible sigmoidoscopy? First, it should be acknowledged that flexible sigmoidoscopy reduces colorectal-cancer incidence and mortality for the portion of the colon that it is designed to examine. Next, high-quality evidence must show the superiority of colonoscopy over other screening tests before we dismiss the use of flexible sigmoidoscopy and fecal occult-blood testing, both of which have randomized, controlled trials supporting their benefit. Especially critical are data that confirm the ability of colonoscopy to reduce mortality from proximal cancers. Finally, patient preferences for screening tests should be identified and respected — in this case, the best test is the one that gets done.