SAN FRANCISCO--Average-risk individuals over age 50 can be effectively
screened for colorectal cancer by use of annual fecal occult blood
testing and sigmoidoscopy every 5 years, John H. Bond, MD, said
at a press conference during Digestive Disease Week (DDW).
An educational campaign launched at the meeting is designed to
raise public awareness about the importance of screening and spur
primary care physicians to suggest colorectal screening to appropriate
"Two large prospective randomized trials performed at my
institution, the University of Minnesota, and at Memorial Sloan-Kettering
Cancer Center, have now reported definitive end point results
showing that this form of cancer screening will reduce colorectal
cancer deaths by 50%," Dr. Bond said.
Dr. Bond countered the critics of such screening who point out
its limitations. "There are some limitations with any simple
screening test, and further research is needed in some areas,
but I feel the critics have almost gone too far and are interfering
with the implementation of the tests today," he said.
Critics have argued that colorectal screening is not sensitive
enough in detecting cancers, but Dr. Bond said that the two large
US studies have shown that very few colorectal cancers are missed
with the type of screening that is being recommended. "Sensitivity
was 92% in the Minnesota trial, meaning that this form of screening
picked up 92 of 100 cancers at an early asymptomatic stage,"
Others have argued that screening should not be implemented until
results from the three ongoing European studies are available,
but Dr. Bond pointed out that all of the preliminary data from
these studies are "absolutely consistent" in showing
reduced mortality, detection at an earlier stage, and longer survival
after surgery in screened populations.
"There just isn't likely to be any new substantial information
that will alter these recommendations at least for the next 10
to 20 years until we have maybe some new way of screening for
colorectal cancer," he said.