30 April 2010
Screening test could cut bowel cancer deaths
Research published this week in the medical journal The Lancet suggests that deaths from bowel cancer could be reduced by having a single screening test.
This randomised controlled trial looked at whether people who had a flexible sigmoidoscopy test were less likely to get bowel cancer or die from it than a group of similar people who didn't have the screening test. The researchers studied over 170,000 men and women in the UK. Of these, 40,000 went for a flexible sigmoidoscopy between the ages of 55 and 64. The researchers recorded how many people developed cancer in any part of their bowel in the 11 years following the test. They compared their findings with the group who didn't have the test.
Bowel cancer usually occurs as a result of small growths called polyps that develop from the lining of the bowel. Polyps are non-cancerous (benign) but some may become cancerous over time. A flexible sigmoidoscopy uses a narrow, tube-like, telescopic camera to look at the inside of the rectum (back passage) and the lower part of the bowel. Two-thirds of all bowel cancers are found in these areas and are called distal cancers. The test doesn't look at parts of the bowel that are higher up (proximal cancers). Any polyps that are found during a flexible sigmoidoscopy can be removed at the same time, dramatically reducing the risk of cancer developing. Some people who have high-risk polyps may need to have more tests.
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Dr Peter Mace, Assistant Medical Director, Bupa |
More research is needed to directly compare different screening tests, including virtual colonoscopy, on the death rate from bowel cancer before we can say which is the best method. 
The participants in the study had flexible sigmoidoscopy in a hospital clinic; only one test was done. Those people who didn't have any polyps had no further treatment or tests; people who had high-risk polyps were referred for more tests.
The results of the study showed that the people who had the screening test were less likely to develop distal cancers than those who didn't have it. There was no difference between the two groups in the number of people who developed proximal bowel cancers. However, this is to be expected because flexible sigmoidoscopy doesn't look at this part of the bowel.
Overall, the researchers found that the people who had the screening test were a third less likely to develop any type of bowel cancer, and 40 percent less likely to die from it. They suggest that offering flexible sigmoidoscopy screening would not only reduce the number of people who get bowel cancer, but also cut the cost of treatment for the disease.
Dr Peter Mace, Assistant Medical Director, Bupa, said: "This study is very encouraging and confirms that screening for bowel cancer is worthwhile and can reduce deaths from this disease. However, the researchers only compared flexible sigmoidoscopy with no screening, rather than comparing it with other methods such as faecal occult blood testing, which is much cheaper and effective.
"More research is needed to directly compare different screening tests, including virtual colonoscopy, on the death rate from bowel cancer before we can say which is the best method.
"Currently at Bupa we offer faecal occult blood testing and virtual colonoscopy for our customers over 45 years old. We will continue to review medical research in this area to get the best evidence to help improve our customers' health."
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Related information
Read the study
Atkin WS, Edwards R, Kralj-Hans I, et al. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet 2010. doi: 10.1016/S0140-6736(10)60551-X
