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}
}

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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.
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.
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.
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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.
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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.
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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.
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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.
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TLDR
Screening sigmoidoscopy was associated with a statistically significant reduction in the incidence of distal colorectal cancer and these reductions were sustained for up to 16 years with little attenuation.
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