Barium enemas found such lesions in only 39 percent of the patients in which they were detected by colonoscopy. The barium enemas also only detected 48 percent of larger lesions, which cause problems because they are more likely to become cancerous. Current American Cancer Society guidelines for colorectal cancer screening are a fecal occult test, or a blood test that detects hidden blood in the stool, every year for a person over the age of 50 and a flexible sigmoidoscopy, an endoscope that examines half the colon, every five years. Alternatively, the recommendations call for a person over the age of 50 to either have a colonoscopy every 10 years or a barium enema every 5 years to 10 years. In practice, most people in the United States undergo the blood test and sigmoidoscopy because health insurance plans usually only pay for these two methods.
Individuals pay out of pocket for a colonoscopy.
While the literature has been mixed, we can now say with a high degree of confidence that the barium enema was not very effective in detecting colon polyps of any size, including larger ones, and it was not shown effective in any particular part of the colon. 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.