The SOCCER study examined the symptoms patients with colorectal cancer present with and whether certain signs or symptoms can indicate the location of the tumour, allowing a less invasive examination for some patients.
Scientific evidence for doctors
SOCCER provided evidence that flexible sigmoidoscopy is an effective and safe alternative to whole colon examinations for many people.
The main findings of our study were that patients with rectal bleeding or increased stool frequency, but with no anaemia or lump in the abdomen, had a very low risk (0.4%) of having cancer in the upper/proximal part of the colon. These patients could therefore safely undergo a flexible sigmoidoscopy alone, which only examines the lower/distal colon and is a much quicker, easier and cheaper examination that is associated with lower risks than whole colon investigation.
The study determined which patients with suspected colorectal cancer could be offered flexible sigmoidoscopy rather than a whole colon investigation. Incorporating these findings into guidelines will help GPs make better referral decisions and reserve whole colon investigations for patients who need them the most. This can help the NHS make best use of its stretched endoscopy resources as well as ensure patients are not being put at unnecessary risk of having invasive exams that they do not need.