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[Comment] Flexible sigmoidoscopy screening: is once enough?

Worldwide, colorectal cancer is the third most common incident cancer and the fourth leading cause of cancer death, with 1·4 million new cases and 700 000 deaths estimated in 2012—most of these from the developed world.1 Over the past three decades, several methods to screen for colorectal cancer, and to detect, remove, or both, colorectal cancer precursors—namely, adenomatous polyps—have been developed. Current guidelines in the European Union include recommendations for stool-based tests (fecal occult blood test [FOBT] and fecal immunochemical test [FIT]) and flexible sigmoidoscopy, whereas most US guidelines include those tests as well as colonoscopy.