The purpose of this review was to compare the two screening methods (FOBT and flexible sigmoidoscopy) in their ability to reduce the number of deaths due to cancer in the large intestine and rectum. We identified four trials which compared FOBT to no screening and five trials which compared flexible sigmoidoscopy to no screening. No studies compared the two methods directly. Mortality from colorectal cancer was reduced with FOBT screening and screening with flexible sigmoidoscopy.
When we compared the two methods, we could not conclude that one was better than the other. No complications occurred after the FOBT test itself, but 0.03% of participants suffered a major complication after follow-up. Among more than 60,000 flexible sigmoidoscopy screening procedures and almost 6000 work-up colonoscopies, a major complication was recorded in 0.08% of participants. These findings should be interpreted with caution as the reporting of adverse effects was incomplete.
Reference:
Øyvind Holme, Michael Bretthauer, Atle Fretheim, Jan Odgaard-Jensen, Geir Hoff: Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals, The Cochrane Library, Published Online: 30 SEP 2013