Navigate Up
UPMC/University of Pittsburgh Schools of the Health Sciences
Manager
Telephone: 412-623-4701 or 412-586-9773

Patients and medical professionals may call 1-800-533-UPMC (8762) for more information.
 

UPMC Media Relations

University Of Pittsburgh-Led Study Finds Benefit To Repeating Sigmoidoscopy Three Years After A Negative Exam

PITTSBURGH, July 1, 2003 According to findings published in the July 2 issue of the Journal of the American Medical Association (JAMA), repeating flexible sigmoidoscopy three years after a negative exam can detect advanced adenomas (pre-cancerous polyps or growths in the lining of the large intestine) and distal colon cancer, raising concern about the impact of delaying repeat screening for prolonged intervals.

Our study found a three-to-four fold increase in detection from the initial exam compared to the next exam three years later. The findings at the three years, although modest, indicate that more frequent screening for colon cancer, by detecting pre-cancerous growths, could have an impact on mortality from this disease, said Robert Schoen, M.D., M.P.H, lead author of the study and associate professor of medicine and epidemiology, University of Pittsburgh School of Medicine. Our findings raise concern that a longer interval between exams, such as the currently recommended 10-year interval for repeat colonoscopy after a negative exam, may result in morbidity and mortality from colorectal cancer. This is especially suggested by the fact that over 80 percent of the advanced lesions found on the repeat exam three years later were found in a region of the colon that, as far as can be determined, was well examined the first time around, added Dr. Schoen, who also is director of colorectal and gastrointestinal cancer prevention and control research at the University of Pittsburgh Cancer Institute.

During flexible sigmoidoscopy (FSG), a doctor uses a lighted scope to examine the inside of the large intestine from the rectum through the last part of the colon, where most colon polyps develop.

The study included individuals enrolled in the Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) Screening Trial, a randomized, community-based study evaluating the effectiveness of cancer screening tests on site-specific mortality. Subjects in the study were eligible for repeat FSG three years after an initial negative result. The mean age of those who returned for repeat screening was 65.7 years. Of the 9,317 individuals who returned for repeat FSG, 13.9 percent (1,292) had a polyp or mass, 3.1 percent (292) were found to have a non-advanced adenoma and 0.8 percent had an advanced adenoma or cancer in the distal colon.

While the overall percentage of detected abnormalities was modest, these data question the notion that individuals with initial negative results can wait for prolonged periods of time to be re-screened, said Dr. Schoen.

Colorectal cancer is a worldwide public health problem. In the United States, colorectal cancer accounts for 11 percent of all cancers, with 147,330 new cases and 56,000 deaths expected in 2002. For patients with advanced disease, five-year survival rates are 10 to 20 percent. However, when colorectal cancer is diagnosed at an early, localized stage, the five-year survival rate is 90 percent.

Co-authors of the study include Joel L. Weissfeld, M.D., M.P.H., University of Pittsburgh; Paul F. Pinsky, Ph.D., Philip Prorok, Ph.D., and John K. Gohagan, Ph.D., National Cancer Institute; Robert S. Bresalier, M.D., MD Anderson Cancer Center; and Timothy Church, Ph.D., University of Minnesota.

NOTE TO TV EDITORS: The July 1 JAMA Report, a video news release available via satellite, features an interview with Dr. Schoen and a patient in the study, 9 to 9:30 A.M., ET and 2 to 2:30 P.M., ET Telstar 6 (C), Transponder 11. Downlink Frequency: 3920 Vertical. Audio: 6.2/6.8.

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com