Trial of 'once-only' flexible sigmoidoscopy in prevention of colorectal cancer morbidity & mortality.

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Bowel cancer causes 20,000 deaths each year. We have proposed that a ?once-only? flexible sigmoidoscopy at about age 60, with colonscopy for the 3-5% with ?high-risk? adenomas (multiple, >1cm, villous or severely dysplastic) could reduce the incidence and mortality by 45% among those screened. If implemented nationally, we estimate it could prevent 5,500 colorectal cases and 3,000 deaths in t he UK each year. Programme costs would be #30 million per year and present predictions indicate that it might cost #7,000 per cancer prevented or #12,000 per cancer death prevented. We are currently undertaking a multicentre randomised trial. It is designed to quantify the reduction in colorectal cancer incidence and mortality and to refine the cost-benefit analyses. The recruitment and screening phases of the trial are now almost complete, with 365,000 sent initial questionnaires and more than 39,000 screened. We now seek an extension of funding to ensure that follow-up of the trail cohort is complete and timely and that all planned subsidiary analyses can be undertaken.