Impact of sigmoidoscopy and colonoscopy on colorectal cancer incidence and mortality: an evidence-based review of published prospective and retrospective studies.

14 In contrast, by intention-to-treat analysis, the Italian SCORE Trial showed a reduction of 22% for CRC mortality, which did not reach statistical significance, but per protocol analysis resulted in a significant 38% reduction. 17 Other early randomized studies were not able to demonstrate beneficial effects of sigmoidoscopy on CRC mortality. 15 , 18 In the last few years, more conclusive data became available from the United Kingdom Flexible Sigmoidoscopy Trial, which showed a significant reduction in CRC mortality of 31%, 13 while the American PLCO Trial showed a reduction of 26%. 16 With regard to overall mortality, the data to date have been less encouraging.

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