Experts say yes, and now they have data to show that giving patients a choice of colon cancer screening tests is good business, as well as good medicine. The two things people should consider are annual fecal occult blood tests plus flexible sigmoidoscopy every five years, or colonoscopy every 10 years. Frazier, an oncologist at Boston's Dana-Farber Cancer Institute, is author of a study that used a mathematical model to compare all 22 colon cancer screening strategies now available.
Colon cancer starts with the formation of small, noncancerous growths called polyps.
Over time, these polyps can gradually become larger, and some eventually become invasive cancers. Because this process takes about 10 years, there is lots of time to find and remove polyps before they become malignant. Screening with fecal occult blood test every year combined with flexible sigmoidoscopy every five years was the most cost-effective strategy. A second study by Amnon Sonnenberg, MD, and colleagues at the Veterans Affairs Medical Center in Albuquerque, N.M., found colonoscopy to be more cost-effective than either fecal occult blood test or sigmoidoscopy alone. Commenting on this study, University of Pennsylvania researcher James D. Lewis, MD, MSCE, suggests that colonoscopy is an attractive alternative for patients.