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Worth of Sigmoidoscopy Screening for Colon Cancer Still Uncertain
Date:6/1/2009

,000 men and women, aged 55 to 64, to be invited to screening for colon cancer with flexible sigmoidoscopy, while the others were not invited. The researchers followed all the participants for an average of seven years.

Hoff's group found no significant difference between the two groups in the number of those who developed colon cancer. Among those in the group that was invited to get screened, death from colon cancer was reduced by 27 percent compared with those who were not screened, but that percentage was not statistically significant, the researchers noted.

However, for those who actually underwent screening, death from colon cancer was reduced by 59 percent compared with people in the non-screening group. Moreover, for cancers that could have been found by flexible sigmoidoscopy, death from colon cancer was reduced by 76 percent, the team noted.

Both reductions in mortality are significant, the researchers say. But according to Hoff, the drop in deaths might also be due to what researchers call "self-selection bias": Heath-conscious people may be the ones choosing to get screened.

"A major reason for non-compliance to screening is that people are not convinced that there is 'anything in it for them,'" Hoff said. "Being able to quantify an effect to present potential screening participants requires randomized trials like this one. The study illustrates the need for randomized population screening trials before recommending widespread use of screening."

Dr. Thomas Imperiale, a professor of medicine at Indiana University Medical Center in Indianapolis and author of an accompanying journal editorial, noted that seven years was still too short a time to see a reduction in colon cancer from screening. And he advises everyone that it's better to get screened than not.

"These are early results. They show some promising findings," Imperiale said, but "we would not yet expect to see a reduction in colorectal c
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