Intest Res.  2014 Oct;12(4):268-274. 10.5217/ir.2014.12.4.268.

Impact of Sigmoidoscopy and Colonoscopy on Colorectal Cancer Incidence and Mortality: An Evidence-Based Review of Published Prospective and Retrospective Studies

Affiliations
  • 1Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA. Otto.Lin@vmmc.org
  • 2Gastroenterology Division, University of Washington School of Medicine, Seattle, WA, USA.
  • 3Gastroenterology Division, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Korea.

Abstract

Screening for colorectal cancer (CRC) using sigmoidoscopy or colonoscopy is now common in many developed countries. This concise, evidence-based review looks at the impact of sigmoidoscopy or colonoscopy screening on CRC incidence, CRC mortality and overall mortality. Data from controlled retrospective and prospective (observational or randomized) studies have generally shown that sigmoidoscopy and colonoscopy, whether for diagnostic, screening or surveillance purposes, are associated with a significant reduction in CRC incidence and CRC mortality. The data on their impact on overall mortality is much more limited, with most studies unable to report a reduction in overall mortality. The results of three meta-analyses have confirmed these conclusions. As expected, sigmoidoscopy has a predominant effect on left-sided CRC, although some studies have shown modest effects on right-sided colon cancer as well. Most studies on colonoscopy have demonstrated that the protective effect applies to both right and left-sided cancer, although the protection seemed better on the left side. Despite the introduction of other screening and diagnostic modalities for the colon, such as computed tomography colonography and colonic capsule endoscopy, lower endoscopy will continue to be an important mode of screening for CRC and evaluating the colon.

Keyword

Colon; Colonoscopy; Neoplasms; Screening; Sigmoidoscopy

MeSH Terms

Capsule Endoscopy
Colon
Colonic Neoplasms
Colonoscopy*
Colorectal Neoplasms*
Developed Countries
Endoscopy
Incidence*
Mass Screening
Mortality*
Prospective Studies*
Retrospective Studies*
Sigmoidoscopy*

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