Are we nearing the end of the road for the sigmoidoscope?

As medical technology continually advances and clinical practice evolves, some technologies inevitably become redundant.

One that may suffer this fate over the next 15 years is the sigmoidoscope, which is being used less and less frequently in most countries across the world, leading to fewer sales of the device globally.

The reason for the global decrease is that sigmoidoscopes can only be used to examine the sigmoid (the most distal part of the colon). Clinicians are therefore favouring colonoscopes, which can be used to explore the entire colon to detect colorectal cancer.

As healthcare spending is squeezed across the world, it appears that most payers have decided that colonoscopes alone are sufficient and sigmoidoscopes are an unnecessary expense. As sigmoidoscopes detect only 70% of colorectal cancer cases and polyps due to their reduced insertion depth in the bowel, colonoscopes also confer medical advantages. For this reason, the American Cancer Society already recommends colonoscopy following positive sigmoidoscopy results.

At $33.32m, the market value for sigmoidoscopes is already less than two-thirds of what it was in 2005, when it stood at $54.17m. This equates to a 3.6% decrease in the market year-on-year. The sigmoidoscope market is likely to decrease even further and faster. However, with an expected 5.4% year-on-year decrease going forward to 2024, GlobalData does not expect the market to exceed $25m.

This market is being sustained by the US, which is currently responsible for almost half of the total market value due to strong reimbursement for colorectal cancer screening under the Affordable Care Act. The decrease in the usage of sigmoidoscopes in the US is not expected to be as rapid as elsewhere. As a result, the US’ proportion of the market will rise to nearly 60% by 2024. Sigmoidoscopy remains one of the recommended colorectal cancer screening techniques by the Centers for Disease Control and Prevention (CDC) and the American Cancer Society.

There are various benefits to sigmoidoscopy when compared to colonoscopy, including the fact that sedation is not normally required, preparation for the procedure is not as severe, and both the procedure and recovery time are reduced. However, it does not appear that these advantages will be enough to stop the downward trend being seen as colonoscopy takes over.

With the number of sigmoidoscopes sold annually in many countries now into single digits, it seems that in some parts of the globe the sigmoidoscope is becoming a very rare thing indeed.