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In the colorectal cancer screening arm of the U.S. Prostate, Lung, Colorectal, and Ovarian (PLCO) trial, 156,000 people (age range, 55–74) were randomized to either flexible sigmoidoscopy (with a second screening 3 or 5 years later) or usual care. The researchers now report outcomes after a median follow-up of 12 years.
Compared with the usual-care group, the screening group had significantly lower colorectal cancer incidence (about 1.66% vs. 1.31%) and cancer-specific mortality (about 0.44% vs. 0.33%). For distal cancer, screening reduced both incidence and mortality; for proximal cancer, screening was associated with reduced incidence but not mortality.
Other important aspects of the study are as follows:
Only 84% of people assigned to scree…