Dr. John Bond, professor of medicine at the University of Minnesota, one of the centers in the trial, says the findings show barium enemas should no longer be considered an option for diagnosis. Winawer says he believes the study results should influence organizations about their policies regarding colorectal cancer screening. Indeed, Dr. Harmon Eyre, the American Cancer Society's chief medical officer, said his group would be reviewing their recommendations about barium enemas as the alternative method for colorectal cancer screening. The colonoscope, which is connected to a video camera, provides a view of the colon's lining. Surgical devices also can be slipped through the scope to remove growths.
Colonoscopy requires sedation and usually is performed on an outpatient basis in the hospital.
Barium enemas involve putting barium sulfate, a chalky substance, into the anus to fill and open up the colon. X-rays can detect lesions. Although colonoscopy is more expensive, the procedure has the advantage of removing polyps when they are detected, Bond says. Sigmoidoscopes do not allow for removal of tissue. Another issue for massive colonoscopy screening is that there may also not be enough gastroenterologists in the country to screen the general population, says the American Cancer Society's Eyre.