Both Lower Endoscopy and FOBT Found Effective in Colorectal Cancer Screening
The benefits of screening for colorectal cancer, regardless of approach, are made apparent in two New England Journal of Medicine studies.
The first study comprises almost 90,000 clinicians followed for 22 years. Relative to no self-reported endoscopy, those who underwent sigmoidoscopy had an approximately 40% reduction in colorectal cancer mortality; the reduction was even higher with colonoscopy (70%).
The second study examines 30-year outcomes in some 47,000 people randomized to usual care or to annual or biennial fecal occult-blood testing (FOBT) during two 6-year spans. Compared with usual care, the relative risk for colorectal cancer death was 0.68 for annual screening and 0.78 for biennial screening.
Editorialists warn against comparing endoscopy versus FOBT on the basis of these studies, since screening technologies have changed over the years and ongoing trials are addressing their comparative effectiveness.