Most Read Articles
Dr Margaret Shi, 02 Jan 2020

Tivozanib as third- or fourth-line therapy improves progression-free survival (PFS) compared with sorafenib in patients with metastatic renal cell carcinoma (mRCC) who have received ≥2 previous systemic treatments, according to results of the phase III, randomized, controlled TIVO-3 trial.

Sigmoidoscopy screening cuts colorectal cancer incidence, mortality

30 Oct 2019

Sigmoidoscopy and guaiac faecal occult blood test (gFOBT) screening confer benefits for colorectal cancer incidence or mortality, according to a network meta-analysis.

Researchers searched multiple online databases for randomized controlled trials that evaluated the impact of annual or biennial gFOBT or faecal immunochemical test (FIT), once-only sigmoidoscopy on the following outcomes: colorectal cancer incidence and mortality, all-cause mortality, harms (bleeding, perforation, screening-related death and other major and minor complications), and burdens (need for further diagnostic workup including colonoscopy, procedure-related pain, psychological impact of a positive test and absence from work).

A total of 12 trials were included in the network meta-analysis: five on gFOBT screening, two on FIT screening, five on sigmoidoscopy screening and two on colonoscopy screening. The overall population comprised 1,325,618 participants aged 45–80 years with follow-up ranging from 0 to 19.5 years for colorectal cancer incidence and from 0 to 30 years for colorectal cancer mortality.

Compared with no-screening, sigmoidoscopy screening produced numerical reductions in colorectal cancer incidence (relative risk [RR], 0.76, 95 percent CI, 0.70–0.83) and mortality (RR, 0.74, 0.69–0.80), whereas gFOBT screening exerted little or no difference in colorectal cancer incidence but marginally decreased colorectal cancer mortality (annual: RR, 0.69, 0.56–0.86; biennial: RR, 0.88, 0.82–0.93). None of the screening test examined reduced colorectal cancer mortality or incidence by >6 per 1,000 screened over 15 years.

Notably, sigmoidoscopy had a stronger effect in men, for both colorectal cancer incidence (women: RR, 0.86, 0.81–0.92; men: RR, 0.75, 0.71–0.79) and mortality (women: RR, 0.85, 0.71–0.96; men: RR, 0.67, 0.61–0.75).

The present data demonstrate that sigmoidoscopy screening slightly reduces colorectal cancer incidence even 15 years after a once-only screening, according to researchers. To date, most guidelines recommend rescreening 5–10 years after initial screening. This may now be safely extended to 15 years.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Oncology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Dr Margaret Shi, 02 Jan 2020

Tivozanib as third- or fourth-line therapy improves progression-free survival (PFS) compared with sorafenib in patients with metastatic renal cell carcinoma (mRCC) who have received ≥2 previous systemic treatments, according to results of the phase III, randomized, controlled TIVO-3 trial.