Colorectal cancer is the third most common cancer worldwide and it has a high mortality rate. In a 2010 pre-budget announcement, health minister Tony Ryall revealed a four-year pilot screening programme using a two-yearly laboratory test – the faecal occult blood test. In the 8 May 2010 issue of the Lancet, UK researchers report on the usefulness of an alternative method of screening using once-only flexible sigmoidoscopy between 55 and 64 years of age. Flexible sigmoidoscopy uses a flexible tube (endoscope) to inspect the 60cm or so of the rectum and lower colon and could cost around $250 if it were widely available in New Zealand. The UK trial in 14 centres enrolled 170,432 eligible men and women. The participants had previously said they would accept screening and were randomly allocated to be offered flexible sigmoidoscopy or were not invited to have it (control group). The researchers found the procedure substantially reduced the cases and consequences of colorectal cancer over a median follow-up of 11.2 years; adjusting for influencing factors, the incidence of colorectal cancer was reduced by 33% and deaths by 43%. For every 191 people screened, one cancer diagnosis was prevented and for every 489 screened one death was prevented, during the study period. The researchers concluded that, "Flexible sigmoidoscopy is a safe and practical test and, when offered only once between ages 55 and 64 years, confers a substantial and long-lasting benefit." A full colonoscopy remains the “gold standard” investigation as it allows inspection of the entire length of the colon, but is more expensive at around $1600.