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Robert H. Fletcher, MD, MSc

JAMA. 2003;290:106-108.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Flexible sigmoidoscopy is a member in good standing in the family of screening tests for colorectal cancer. Consistent evidence shows that even a single screening sigmoidoscopy reduces mortality from colorectal cancer by two thirds in the area examined, about half of the large bowel.^1-4 All major screening guidelines recommend sigmoidoscopy, often coupled with fecal occult blood testing.^5-7 In the United States, more than half of patients appropriately screened have had sigmoidoscopy.⁸ The cost-effectiveness of screening sigmoidoscopy compares favorably with other recommended screening tests for colorectal cancer⁹ and with screening for other cancers.

But several questions remain. How often should sigmoidoscopy be repeated in the course of a screening program? Is sigmoidoscopy a good enough option relative to other available tests, such as colonoscopy? How can sigmoidoscopy be made available to all adults who want to be screened in this way?

In this issue of THE . . . [Full Text of this Article]

Author Affiliation: Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, Mass.

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