Long-term follow-up of the Italian Flexible Sigmoidoscopy Screening Trial

The Italian Flexible Sigmoidoscopy Screening Trial randomized persons aged 55 to 64 years 1:1 to invitation for a single flexible sigmoidoscopy (FS) screening or usual care. During median 15.4 years of follow-up for CRC incidence and 18.8 years for CRC mortality, the CRC incidence was reduced by 19% in the FS group versus the control group (RR 0.81; 95% CI 0,71-0.93), while the CRC mortality was reduced by 22% (0.78; 0,61-0.98). Among the persons who accepted the invitation and were screened (58% of the invited group) the CRC incidence was reduced by 33% (RR 0.67; 95% CI 0.56-0.81) compared to the control group, while the CRC mortality was reduced by 39% (0.61; 0.44-0.84). The authors conclude that the strong protective effect of a single FS screening for CRC incidence and mortality was maintained up to 15 and 19 years, respectively.