Colonoscopy Catches More Colorectal Cancers Than Flexible Sigmoidoscopy

The rate of new or missed left-sided colorectal cancers quadrupled with flexible sigmoidoscopy compared with colonoscopy in a retrospective analysis of 25,541 cases, according to research presented at the annual Digestive Disease Week and reported in Internal Medicine News.

The overall interval CRC rate, defined as colorectal cancer diagnosed 6-36 months after a lower endoscopy, was 11.7 percent after flexible sigmoidoscopy. After colonoscopy, overall interval colorectal cancer rates were only 2.6 percent.

The rate of interval CRCs was higher after sigmoidoscopy than colonoscopy in all locations, including the descending colon (18.7 percent compared to 3.3 percent), rectum (12.5 percent compared to 2.7 percent), left colon combined (11.7 percent compared to 2.66 percent), sigmoid colon (11.3 percent compared to 2.4 percent) and rectosigmoid junction (8 percent compared to 2.2 percent).

According to the report, colonoscopy typically requires sedation, which sigmoidoscopy does not, and has a higher perforation rate — but, unlike sigmoidoscopy, the procedure allows for examination of the entire colon. Yize Richard Wang, MD, who reported the results at DDW, concluded that despite colonoscopy's imperfections, it remains the "gold standard" for detection and prevention of CRC.

Read the Internal Medicine News report on colonoscopy.

Related Articles on Colonoscopy:
10 Gastroenterologists in New Positions
Free 'Colonoscopy for Dummies' Guide Available for Download
Henry Ford Open Access Colonoscopy Programs Safe and Effective

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