Contact: Jeffrey Macdonald (202) 973-2903
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Jennifer Armstrong (202) 973-2930
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Colonoscopy Offers Most Complete Cancer Screening: Malignancies Increasingly Appear in Right Side of Colon, Out of Reach of Flexible Sigmoidoscope
Phoenix, AZ, October 18, 1999 -- Research conducted at Albert Einstein Medical Center in Philadelphia, PA and presented at the Annual Scientific Meeting of the American College of Gastroenterology (ACG) confirms studies which have documented the migration of colon cancer proximally, that is increasingly located in the right side of the colon. These findings suggest that screening exams which allow physicians to visualize the entire colon are more likely to detect lesions in the right side of the colon, unlike flexible sigmoidoscopy, which only examines the lower one-third of the colon.
Researchers working with Frank K. Friedenberg, MD reviewed 11,303 consecutive patient records for colonoscopies performed between 1985 and 1998. Findings were classified as to whether the lesions would have been within reach of a 60 centimeter flexible sigmoidoscope. Within this population 655 lesions were detected, but only 625 were confirmed as cancerous. Over the 14-year study period, there was a substantial migration toward the proximal -- or right side -- of the colon. In 1985, 64.9% of cancers were within reach of the flexible sigmoidoscope, compared to 47.8% in 1998. A year by year analysis revealed a strong correlation to migration out of reach of the flexible sigmoidoscope over the length of the study period.
Another study suggesting the benefit of colonoscopy screening was presented at the ACG Annual Scientific Meeting by Philip Schoenfeld, M.D. of the National Naval Medical Center in Bethesda, MD. Dr. Schoenfeld looked at whether the presence of abnormal findings in a flexible sigmoidoscopy correlated with abnormalities in the right side, which could not be detected by flexible sigmoidoscopy. He found that patients with abnormal findings on flexible sigmoidoscopy do not have an increased risk of advanced pre-cancerous lesions in the proximal colon compared to a control group of patients with normal findings from flexible sigmoidoscopy. "My research demonstrates that both groups of patients have an equal likelihood of having a pre-cancerous growth in the proximal colon and that flexible sigmoidoscopy may not be as appropriate a screening test as we would wish," says Dr. Schoenfeld. "Flexible sigmoidoscopy has and can detect colon cancers, however it may not be as comprehensive as other
Colon cancer is the second leading cause of cancer death in the United States. Everyone over 50 should discuss colon cancer screening with his or her physician.
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The ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners. For more information, visit ACG's website: www.acg.gi.org
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