Study backs flexi-scope for bowel screening

In collaboration with the Press Association

Using an internal camera called a flexi-scope to screen for signs of bowel cancer can greatly reduce deaths from the disease, according to a review of previous evidence.

The authors say the results, published in PLoS Medicine, "provide grade A evidence" for the inclusion of the technique in national bowel screening programmes.

The UK government has committed to introduce the technique by 2016, after a landmark UK trial funded by Cancer Research UK showed it could reduce deaths by 43 per cent.

Flexible sigmoidoscopy - also known as flexi-sig or flexi-scope - involves using a flexible tube with a camera and light at the end to look into the lower part of the large bowel. It can spot both early-stage cancers and pre-cancerous polyps.

Led by Dr Joseph Elmunzer from the University of Michigan Medical Center, the review analysed the combined results of five randomised controlled trials, including the UK trial.

It found that, overall, the number of new cancers among those who were screened using flexible sigmoidoscopy was reduced by almost a third (32 per cent), while deaths from bowel cancer were halved.

"These findings provide grade A evidence for the inclusion of flexible sigmoidoscopy in colorectal cancer screening guidelines, akin to the justification afforded to fecal occult blood testing by prior randomized controlled trials," the report's authors said.

"A flexible sigmoidoscopy-based strategy appears highly effective in reducing the incidence and mortality of this malignancy in average-risk patients."

Cancer Research UK welcomed the results, and called for more information on how the roll-out of flexi-scope screening was progressing.

"The results of this overall analysis are similar to our 2010 findings," said Sarah Williams, the charity's health information officer.

"The government has earmarked £60 million to incorporate this test into the national bowel screening programme in England by 2016, and we want to see the new test rolled out without delay.

"We also call on the health services in Scotland, Wales and Northern Ireland to commit to introducing this technique as soon as feasible.

"Flexible sigmoidoscopy saves lives - the sooner it's available on the NHS, the better."

Copyright Press Association 2012


  • Elmunzer B.J. et al. (2012) Effect of Flexible Sigmoidoscopy-Based Screening on Incidence and Mortality of Colorectal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS Med 9(12): e1001352. doi:10.1371/journal.pmed.1001352