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Oncology NEWS International. Vol. 5 No. 7
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Proven: Colorectal Screening Cuts Deaths 50%

July 1, 1996

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 patients.

"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," he said.

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.

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