Colonoscopy vs Sigmoidoscopy: New Studies Fuel Ongoing Debate

Mounting evidence shows that colorectal screening reduces cancer incidence and mortality, but scientists still disagree about the best way to look for risky polyps. Clinicians in the US favor colonoscopy, while European health systems rely far more on flexible sigmoidoscopy–a cheaper, less invasive method that can be performed without sedation, but that also reaches only into the distal or “left” side of the colon, while leaving the proximal or “right” side nearer to the large intestine un-monitored. According to Martin Brown, M.D., chief of the health services and economics branch at the National Cancer Institute (NCI), colonoscopy rates among those eligible for the procedure in the US (generally individuals aged 50 and over) climbed dramatically after Medicare began covering the procedure–from 19% in 2000 to 54.6% in 2010. Rates of flexible sigmoidoscopy (in combination with fecal occult blood testing, or FOBT) declined from 9.4% to 1.3% over the same time period.