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Flexible sigmoidoscopy screening for colorectal cancer

BMJ 2017; 356 doi: (Published 13 January 2017) Cite this as: BMJ 2017;356:j75
  1. Ulrike Haug, professor of clinical epidemiology12
  1. 1Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany
  2. 2Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany
  1. Correspondence to: U Haug haug{at}

Different outcomes in men and women are a challenge for decision makers

An increasing number of countries have implemented or are about to implement programmes for colorectal cancer screening. Unlike existing screening programmes for breast and cervical cancer, colorectal cancer screening affects both men and women. This trivial and obvious fact entails several questions that are far from trivial—eg, are the established tools for colorectal cancer screening equally effective among men and women? To adequately address this issue, subgroup analyses by sex of randomised screening trials with long term follow-up are needed. However, single trials often do not have a sufficient sample size to allow for meaningful subgroup analyses. Pooling of trials is then the only way to answer these questions. Following this rationale, Holme and colleagues1 initiated a joint analysis of three large scale randomised trials on flexible sigmoidoscopy screening conducted in Italy,2 Norway,3 and the United States,4 and they present the findings in The …

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