Clinical Gastroenterology Vol.23 No.2(2-2)

Theme Current Status of Colorectal Cancer Screening
Title Role of Sigmoidoscopy in Screening for Colorectal Cancer
Publish Date 2008/02
Author Ryoichi Nozaki Coloproctology Center, Takano Hospital
Author Gentaro Sakata Coloproctology Center, Takano Hospital
Author Tomohisa Ohwan Coloproctology Center, Takano Hospital
Author Saburo Hisano Coloproctology Center, Takano Hospital
Author Kazutaka Yamada Coloproctology Center, Takano Hospital
Author Masahiro Takano Coloproctology Center, Takano Hospital
[ Summary ] Several epidemiological studies have proven that screening sigmoidoscopy is effective and contributes to a decrease in mortality rates from colorectal cancer (CRC), especially cancer within the reach of sigmoidoscope. In Japan, an increasing number of institutes have recently used sigmoidoscopy or total colonoscopy (TCS) as a primary examination method in medical check-ups. Sigmoidoscopy is an excellent modality which allows more subjects to be examined in a limited period of time because of easier preparation, safer procedures and shorter examination time compared with TCS. The appropriate interval between sigmoidoscopic examinations in screening for CRC may be 5 years in average-risk people.
In Japan, instead of sigmoidoscopy alone, a combination of sigmoidoscopy and immunological fecal occult blood test (IFOBT) has been used as a screening method for CRC. A combination of sigmoidoscopy and 2-day IFOBT can detect CRC twice as effectively as 2-day IFOBT alone. In particular, this combination is effective and recommended for first-time examinees, and also for individuals 50 or older. The accuracy of the combination of sigmoidoscopy and 2-day IFOBT may be comparable to that of TCS. Therefore, it is recommended that the combination method be used as an effective and useful screening method for CRC, not only for opportunistic screening, such as multiphasic health check-ups or “human dry docks”, but also in mass screening.
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