Predicting advanced proximal colonic neoplasia with screening sigmoidoscopy.

Abstract

Screening for colorectal cancer with sigmoidoscopy is associated with a 30% to 40% reduction in colorectal cancer mortality.^1-3 Sigmoidoscopy has been suggested as an effective approach for population screening for colorectal cancer^4,5 and is a feasible⁶ and cost-effective test.⁷ However, up to 70% of proximal colon cancers lack a distal marker lesion that would prompt a colonoscopy in usual clinical practice.⁸ Performance of more colonoscopies may not be a feasible alternative because they are a key source of cost in a colorectal cancer screening program.⁹