Sigmoidoscopy and faecal occult blood test - a comparative screening trial.

Geir Hoff Telemark Hospital Trust and Cancer Registry of Norway and University of Oslo Colorectal cancer is a major health issue, both globally and in Norway. Bowel cancer screening is perhaps the most effective method to mitigate the consequences of the disease for patients and society. Largescale randomised trials show that screening with sigmoidoscopy and faecal occult blood tests reduce colon cancer mortality. A systematic programme of continuous assessment of the benefits and possible harms of alternative screening methods will ensure the best possible effect. In accordance with recommendations from the Norwegian National Council for Priority Setting in Health Care, a pilot for a national screening programme was launched in 2012. The project is designed as a randomised comparative effectiveness study. The two screening methods, sigmoidoscopy and faecal occult blood tests, were compared 1 : 1 in a group of 140 000 people. Until now, more than 100 000 have been invited. Preliminary experiences from the pilot project for colorectal cancer screening demonstrate the potential to design and implement a regional screening programme without imposing an undue burden on clinical capacity. A regional centre for endoscopy training has been established, and it is expected that the added burden of subsequent surveillance endoscopies can be offset by the increased number of endoscopists resulting from the focus on screening and training.