Screening method not effective for older women
A paper published recently in BMJ shows no effect of sigmoidoscopy screening in women aged 60 years and older. This new finding will have implications for a future Norwegian colorectal cancer screening program, where sigmoidoscopy is one of the recommended screening methods.
PI Michael Bretthauer’s Clinical Effectiveness Group has published the paper Effectiveness of flexible sigmoidoscopy screening in men and women and different age groups: pooled analysis of randomised trials in BMJ. Authors are Øyvind Holme, Robert E. Schoen, Carlo Senore, Nereo Segnan, Geir Hoff, Magnus Løberg, Michael Bretthauer, Hans-Olov Adami and Mette Kalager.
Sex and age matter
The aim of the study was to compare the effectiveness of sigmoidoscopy in screening for colorectal cancer by patient sex and age. Data from three large scale randomised trials showed a difference in the effect of screening between the sexes; sigmoidoscopy screening reduces incidence of colorectal cancer in men, and in women younger than 60. In women aged 60 and over, incidence of colorectal cancer was not reduced by screening, possibly because of increased prevalence of cancers in the proximal colon in older women. The proximal colon is not examined during sigmoidoscopy.
Based on these findings, alternative screening methods should be considered for older women, says first author Øyvind Holme.
Screening in Norway
The National council for priority setting in health care has decided to recommend the Norwegian government to initialize a national screening program for colorectal cancer. One of the three proposed methods to include in the program is sigmoidoscopy. The study’s new findings suggest that other screening methods that more effectively detect proximal tumours should be considered in older women.
Latest publicationsBurocziova et al. 2019. Truncated PPM1D impairs stem cell response to genotoxic stress and promotes growth of APC-deficient tumors in the mouse colon. Cell Death. Dis. 10(11): 818
Eilertsen et al. 2019. Technical differences between sequencing and microarray platforms impact transcriptomic subtyping of colorectal cancer. Cancer Lett. [Epub ahead of print] Lopes et al. 2019. Digital image analysis of multiplex fluorescence IHC in colorectal cancer recognizes the prognostic value of CDX2 and its negative correlation with SOX2. Lab. Invest. [Epub ahead of print] Dienstmann et al. 2019. Relative contribution of clinicopathological variables, genomic markers, transcriptomic subtyping and microenvironment features for outcome prediction in stage II/III colorectal cancer. Ann. Oncol. [Epub ahead of print] Totland et al. 2019. Regulation of gap junction intercellular communication by connexin ubiquitination: physiological and pathophysiological implications. Cell. Mol. Life Sci. [Epub ahead of print] All publications