Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial

@article{Atkin2010OnceonlyFS,
  title={Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial},
  author={Wendy S. Atkin and Robert A. Edwards and Ines Kralj-Hans and Kate Wooldrage and Andrew R Hart and John M. A. Northover and David Parkin and Jane Wardle and Stephen W. Duffy and Jack M Cuzick},
  journal={The Lancet},
  year={2010},
  volume={375},
  pages={1624-1633}
}
BACKGROUND Colorectal cancer is the third most common cancer worldwide and has a high mortality rate. We tested the hypothesis that only one flexible sigmoidoscopy screening between 55 and 64 years of age can substantially reduce colorectal cancer incidence and mortality. METHODS This randomised controlled trial was undertaken in 14 UK centres. 170 432 eligible men and women, who had indicated on a previous questionnaire that they would accept an invitation for screening, were randomly… Expand

Paper Mentions

Interventional Clinical Trial
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ConditionsColorectal Cancer
InterventionBehavioral
Interventional Clinical Trial
Through this program, the investigators will test a systematic colon cancer screening outreach strategy for increasing screening completion among uninsured patients, not up-to… Expand
ConditionsColorectal Cancer
InterventionOther
Interventional Clinical Trial
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ConditionsColorectal Adenoma, Colorectal Cancer
InterventionOther, Procedure
Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial--SCORE.
TLDR
A single flexible sigmoidoscopy screening between ages 55 and 64 years was associated with a substantial reduction of CRC incidence and mortality. Expand
Effect of flexible sigmoidoscopy screening on colorectal cancer incidence and mortality: a randomized clinical trial.
TLDR
In Norway, once-only flexible sigmoidoscopy screening or flexible sigmatoscopy and FOBT reduced colorectal cancer incidence and mortality on a population level compared with no screening. Expand
Effectiveness of flexible sigmoidoscopy screening in men and women and different age groups: pooled analysis of randomised trials
TLDR
Flexible sigmoidoscopy is an effective tool for colorectal cancer screening in men and younger women but the benefit is smaller and not statistically significant for women aged over 60; alternative screening methods that more effectively detect proximal tumours should be considered for these women. Expand
Invitation for flexible sigmoidoscopy screening reduced colorectal cancer and colorectal cancer mortality
TLDR
The effects of screening seemed to be robust enough not to be strongly affected by differences across the trials in CRC prevalence, willingness to be screened, threshold for follow-up colonoscopy, and unplanned screening among controls. Expand
Long term effects of once-only flexible sigmoidoscopy screening after 17 years of follow-up: the UK Flexible Sigmoidoscopy Screening randomised controlled trial
TLDR
A single flexible sigmoidoscopy continues to provide substantial protection from colorectal cancer diagnosis and death, with protection lasting at least 17 years. Expand
Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals.
TLDR
There is high quality evidence that both flexible sigmoidoscopy and faecal occult blood testing reduce colorectal cancer mortality when applied as screening tools and low quality indirect evidence that screening with either approach reduces coloreCTal cancer deaths more than the other. Expand
Flexible sigmoidoscopy for colorectal cancer screening: more evidence, persistent ironies.
TLDR
Results of a large randomized trial of colorectal cancer screening in Norway in which one-time flexible sigmoidoscopy was compared with no screening maintain that sigmoidsoscopy and FOBT are still appropriate initial screening options. Expand
Flexible sigmoidoscopy screening: is once enough?
TLDR
The findings of Atkin and colleagues’ extended followup should inform future modelling efforts and lead to a better understanding of the natural history of adenoma, as well as provide needed data from a public health perspective on the optimal design of a screening programme that incorporates flexible sigmoidoscopy. Expand
Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy.
TLDR
Screening with flexible sigmoidoscopy was associated with a significant decrease in colorectal-cancer incidence (in both the distal and proximal colon) and mortality (distal colon only). Expand
Long-term effectiveness of endoscopic screening on incidence and mortality of colorectal cancer: A randomized trial
TLDR
This first randomized trial on the long-term effect of endoscopic screening shows reduced CRC incidence and mortality if screening is combined with rigorous surveillance for individuals with polyps, and Colonoscopy screening without such surveillance may not be effective. Expand
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The authors' flexible sigmoidoscopy screening regimen is acceptable, feasible, and safe, and the prevalence of neoplasia is high, and colonoscopy referral rates of 5% are acceptable. Expand
Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomised controlled trial
TLDR
A reduction in incidence of colorectal cancer with flexible sigmoidoscopy screening could not be shown after 7 years’ follow-up and mortality was not significantly reduced in the screening group but seemed to be lower for attenders. Expand
Design of a multicentre randomised trial to evaluate flexible sigmoidoscopy in colorectal cancer screening
TLDR
The trial is sufficiently large to estimate within narrow confidence intervals the magnitude of benefit and the duration of effect and optimum age for a single screen, and also examines the feasibility and acceptability of the screening regimen, and will identify training and quality assurance issues. Expand
Baseline findings of the Italian multicenter randomized controlled trial of "once-only sigmoidoscopy"--SCORE.
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The high yield of advanced adenomas is consistent with the projected impact of sigmoidoscopy screening on colorectal cancer incidence and the duration of the protective effect is presented. Expand
Flexible sigmoidoscopy in the PLCO cancer screening trial: results from the baseline screening examination of a randomized trial.
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Diagnostic follow-up varied according to polyp size, yet cancer or adenoma detection rates met expectations, and acceptance of screening flexible sigmoidoscopy was high. Expand
Uptake, yield of neoplasia, and adverse effects of flexible sigmoidoscopy screening
TLDR
Compliance rates, yield of adenomas, and referral rate for colonoscopy were as expected, but cancer detection rates were higher, and one person died following surgery. Expand
Prevention of colorectal cancer by once-only sigmoidoscopy
TLDR
It is demonstrated that most of the benefit from the US screening policy would accrue from a single flexible sigmoidoscopy examination at age 55 to 60 years with appropriate colonoscopic surveillance for the 3% to 5% found to have high-risk adenomas, thus saving 40,000 years of life. Expand
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Screening by sigmoidoscopy can reduce mortality from cancer of the rectum and distal colon and a screening once every 10 years may be nearly as efficacious as more frequent screening. Expand
Uptake of population-based flexible sigmoidoscopy screening for colorectal cancer: a nurse-led feasibility study
TLDR
Attention rates in this pilot for nurse-led, population-based FS screening were higher than those reported in other FS studies, and comparable with adherence to fecal occult blood testing (FOBT) in the UK FOBT pilot. Expand
Acceptability of flexible sigmoidoscopy screening in older adults in the United Kingdom
TLDR
In the context of a clinical trial with dedicated trial staff, FS is a well tolerated procedure and there are high levels of satisfaction with service provision and positive attitudes towards the programme. Expand
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