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Evidence suggests that endoscopic screening prevents colorectal cancer. Norwegian investigators report interim results from a trial involving 56,000 older men and women (age range, 55–64) who were randomized to one-time screening with flexible sigmoidoscopy (14,000) or to usual care (42,000). Only 65% of those invited to be screened actually underwent the procedure. A positive screening test — defined as “any polyp 10 mm or more in diameter, any histologically verified adenoma irrespective of size, carcinoma, or a positive occult blood test” — prompted colonoscopy, which was performed in 21% of screened patients.
After 7 years, the incidence of colorectal cancer was the same in both the group that was invited for screening and the usual-care…