NLM Director’s Comments Transcript
Sigmoidoscopy’s Success?: 07/16/2012

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.

Flexible sigmoidoscopy significantly reduces the incidence of and death from colorectal cancer, finds a new, comprehensive study recently published in the New England Journal of Medicine.

Nevertheless, an accompanying editorial notes the study’s findings do not resolve which of the common screening tests for colorectal cancer optimally reduce mortality, prevent new cases of colorectal cancer, and represent the best choice for men and women.

Three of the common tests for colorectal cancer that are discussed in the editorial are: flexible sigmoidoscopy, a fecal occult blood test, and a colonoscopy. MedlinePlus.gov’s colorectal cancer health topic page adds a barium enema and a digital rectal exam are used to find polyps and colorectal cancer.

MedlinePlus.gov’s medical dictionary explains a sigmoidoscopy is a procedure where a scope (inserted in the body) searches some regions of the colon for polyps and possible signs of colorectal cancer. A colonoscopy assesses a larger area (or more regions) of a patient’s colon.

A press release from the National Cancer Institute (NCI) regarding the study’s findings explains a sigmoidoscopy is a less invasive procedure than a colonoscopy and has fewer side effects.

Compared to persons who did not receive screening, the current study suggests a flexible sigmoidoscopy reduced overall colorectal cancer deaths by 26 percent and reduced the incidence of new cases by 21 percent during an 18 year period. The study’s results were based on a randomized clinical trial with almost 155,000 men and women participants, ages 55-74, from 1993-2001.

The study’s participants were part of the National Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, a comprehensive national study, sponsored by NCI.

The accompanying editorial implies the current study provides the most robust findings to date about the health benefits of a flexible sigmoidoscopy.

Despite the study’s robust evidence, the editorial explains its findings do not suggest a sigmoidoscopy is a more clinically efficacious procedure than other colorectal cancer screening options. Instead, the editorial’s author writes the study suggests (and we quote): ‘The quality of evidence supporting the effectiveness of screening colonoscopy is inferior to the quality of data supporting flexible sigmoidoscopy’ (end of quote).        

In an comment that helps patients make screening choices, Christine Berg M.D., one of the study’s 25 authors, said in a NCI press release (and we quote) “The most important message is that, regardless of modality chosen, colorectal cancer screening lowers mortality from colorectal cancer, and all individuals 50 and over should be screened’ (end of quote).

The editorial adds not all adults are willing to undergo a colonoscopy and alternative screening options are helpful for patients and their health care providers. The editorial’s author concludes (and we quote): ‘Patient preferences for screening tests should be identified and respected – in this case, the best test is one that gets done’ (end of quote).

Colorectal cancer is the second leading cause of death from cancer among adults. NCI estimates about 52,000 men and women will die of colorectal cancer in 2012. About 73,000 men and 70,000 women will be diagnosed with colorectal cancer in 2012.

An overview of the common tests used to screen for colorectal cancer is available in the ‘start here’ section of MedlinePlus.gov’s colorectal cancer health topic page. A helpful video about screening procedures (provided by Healthy Roads Media) can be found in the ‘videos’ section of MedlinePlus.gov’s colorectal cancer health topic page.

A guide to how colorectal cancer is diagnosed (provided by NCI) is found in the ‘diagnosis/symptoms’ section.

MedlinePlus.gov’s colorectal cancer health topic page additionally contains links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to related clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. From the colorectal cancer health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.

To find MedlinePlus.gov’s colorectal cancer health topic page, type ‘colon cancer’ in the search box on MedlinePlus.gov’s home page, then, click on ‘Colorectal cancer (National Library of Medicine).’

Specific information about a sigmoidoscopy can be found in the ‘Medical Dictionary’ accessible on the left side of MedlinePlus.gov’s home page. You can get answers to questions that compare a sigmoidoscopy to a colonoscopy and find out more about a flexibile sigmoidoscopy procedure in the ‘specific conditions’ section of MedlinePlus.gov’s colonoscopy health topic page.

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A disclaimer – the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider. I want to take the opportunity to wish you a very happy holiday season and a healthy New Year. The National Library of Medicine and the 'Director's Comments' podcast staff, including Dr. Lindberg, appreciate your interest and company – and we hope to find new ways to serve you in 2012.

I look forward to meeting you here next week.