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Many doctors in the US are recommending screening colonoscopies rather than flexible sigmoidoscopies for healthy subjects with an average risk for developing colon cancer. Colonoscopies are recommended beginning at the age of 50 and thereafter every 7-10 years if no colon polyps or cancers are found. The rationale for this recommendation is:
Colonoscopy examines the entire colon while flexible sigmoidoscopy only examines the rectum and the colon adjacent to the rectum.
Approximately half of colon polyps (and colon cancers) are found in the upper colon (cecum, ascending colon, and transverse colon) and, therefore, are beyond the reach of sigmoidoscopes and would be missed by flexible sigmoidoscopy.
The National Polyp Study, a large, scientific study, has shown that colonoscopy with removal of all colon polyps reduces deaths from colon cancer.
For more information about this procedure, please see the Colonoscopy article.