Single screening sigmoidoscopy linked to lower colorectal cancer risk two decades later

Embargoed for release until 5:00 p.m. ET on Monday 11 May 2026   

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.   
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1. Single screening sigmoidoscopy linked to lower colorectal cancer risk two decades later

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-05456

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A randomized controlled trial of adults in Norway found that a single screening sigmoidoscopy led to a sustained reduction in colorectal cancer (CRC) incidence for more than two decades after screening, with women seeing a more modest risk reduction than men. Sigmoidoscopy screening also reduced the risk of death from CRC in only men. While previous studies have shown sigmoidoscopy screening reduces CRC incidence and mortality for 15 years, these findings suggest that a single flexible sigmoidoscopy can have an even longer-lasting effect on CRC incidence and death, potentially reducing the need for repeated examinations within the usual screening age range. The study is published in Annals of Internal Medicine.

Researchers from the Cancer Registry of Norway, University of Oslo, and colleagues conducted the NORCCAP (Norwegian Colorectal Cancer Prevention) trial to examine whether the benefits of sigmoidoscopy screening for CRC last beyond 15 years. They followed over 98,000 adults aged 50 to 64 in Norway who were randomly assigned to either once-only sigmoidoscopy screening, with or without a stool test, or no screening. After 23 years, sigmoidoscopy screening was associated with a 28% reduction in CRC incidence and a 37% reduction in CRC death in men. In women, sigmoidoscopy screening was associated with an 11% reduction in CRC incidence and no corresponding reduction in CRC death. The authors conclude that a single sigmoidoscopy screening provides a sustained benefit in CRC incidence reduction, particularly in men.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Edoardo Botteri, PhD please email edoardo.botteri@fhi.no.

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2. Heat-related hospitalizations rose nationwide over two decades, with Black adults and low-income communities disproportionately affected

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03390

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A study examined racial and ethnic disparities in rates of heat-related illness (HRI) hospitalizations among U.S. adults from 1998 to 2022. The findings showed that hospitalization rates for HRIs have increased overall in the U.S., with Black adults experiencing the highest rates and greatest increases. People residing in low-income zip codes were also disproportionately affected. The findings are published in Annals of Internal Medicine.

Researchers from the Harvard Medical School and Cambridge Health Alliance used National Inpatient Sample (NIS) data from 1998 to 2022 to analyze HRI hospitalizations among adults aged 18 and older between the months of May to September annually. They identified 168,530 HRI hospitalizations among patients hospitalized as non-Hispanic White (White), non-Hispanic Black (Black), or Hispanic (any race) and calculated age-standardized HRI hospitalization rates per million adults using direct standardization to the 2000 U.S. Census population. The researchers found those residing in low-income ZIP codes were more than twice as likely to be hospitalized with HRIs than those in higher income neighborhoods. HRI hospitalization rates increased nationally for all groups over the time period, but the magnitude of increase varied. Black adults had both the highest HRI hospitalization rates and the steepest increases over time. Regionally, the largest Black-White disparities in rising hospitalization rates were seen in the Midwest and West, while rates increased similarly the fastest for both Black and White adults in the South. The authors conclude that rising temperatures and more frequent heat waves are likely contributing to increasing HRI hospitalizations in the United States. They note that disparities in HRI hospitalizations underscore the importance of prioritizing equity in climate action policies. 

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Dhara Patel, DO, please email dharapatel@hsph.harvard.edu and David Cecere at dcecere@challiance.org.

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3. ACP says telemedicine can offer safe, equitable, and effective access to clinical care, but improvements to the regulatory landscape are needed

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04194

URL goes live when the embargo lifts             

Telemedicine can improve health equity by helping patients overcome barriers to in-person care, but meaningful policy changes are essential for lasting benefits, says the American College of Physicians (ACP). In a new paper, “Telemedicine Policy and Practice: A Position Paper from the American College of Physicians” published in Annals of Internal Medicine, ACP issues recommendations for policymakers, regulators and health systems about how to improve telemedicine. ACP’s recommendations aim to ensure telemedicine is equitable, grounded in evidence, and used as a complement to clinical practice.

Telemedicine has become an essential tool for modern health care. It refers to the remote delivery of clinical services using telecommunication technologies, including video, audio-only, and other digital modalities, and is offered to patients across an array of clinical contexts. When integrated into longitudinal patient-physician relationships, telemedicine can expand access to care and improve clinical outcomes. Patients with mobility, transportation and geographic constraints particularly benefit from telemedicine. For physicians, however, the complex and often fragmented regulatory landscape introduces administrative burden, complicates compliance and can undermine continuity of care.

Safe and effective long-term integration of telemedicine will require deliberate federal and state policymaking. ACP recommends that telemedicine strengthen and facilitate—not replace—in-person care and should promote quality, equitable access, and a meaningful connection between patients and physicians. Telemedicine should be integrated into hybrid models of care that combine in-person and virtual services based on patient needs and clinical appropriateness. Regulators, physician practices, and other relevant entities must address barriers to telemedicine usage by investing in the infrastructure needed to support equitable access, including broadband availability, device access, language services, disability accommodations and digital literacy support. Policymakers should align reimbursement with the clinical value and appropriateness of telemedicine services, rather than adopting one-size-fits-all payment policies, and establish clear, evidence-based national standards that reduce unnecessary variation across state and federal requirements.

Physicians should retain decision-making authority when determining whether telemedicine is clinically appropriate, recognizing that not all conditions can be safely or effectively managed remotely, and regulators should collaborate with them to develop minimum standards for telemedicine safety. ACP supports safe and appropriate prescribing via telemedicine as part of an ongoing patient-physician relationship and emphasizes that telemedicine services should reinforce longitudinal care and avoid fragmenting care through isolated, episodic encounters. ACP also underscores the importance of maintaining coverage for audio-only services when clinically appropriate, particularly for patients facing barriers to video-based care. Physicians face unnecessary administrative barriers to interstate medical practice, which further complicates patient access, and ACP urges policymakers to streamline licensing pathways and enable telemedicine services across state lines. Telemedicine platforms should also meet appropriate standards for patient privacy, data security and clinical safety.

Finally, ACP calls for more research on the operational, workforce and well-being implications of telemedicine on physicians. These studies should guide evidence-based policies that protect physicians and clinicians, sustain telemedicine integration, and strengthen the practice of medicine.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To speak with someone at ACP, please email Jacquelyn Blaser at jblaser@acponline.org.

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4. New commentary shares strategies to address the primary care physician shortage

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-26-01780  

URL goes live when the embargo lifts             

In a commentary published in Annals of Internal Medicine, Kelly L. Graham, MD, MPH, Sara B. Fazio, MD, and Christine Laine, MD, MPH warn of the potential consequences of a predicted shortage of 90,000 primary care physicians (PCPs) by 2040. With only 9% of internal medicine residents choosing primary care, the authors detail different strategies to revitalize the primary care internal medicine pipeline. These strategies include reforming the reimbursement model to more accurately reflect the effort of PCPs, developing multidisciplinary primary care teams to reduce PCP administrative burden and burnout risk, and implementing graduate medical education funding reform to ensure internal medicine residents receive equal training in both inpatient and outpatient settings. The authors argue that the existing funding and training models communicate a lack of prestige among PCPs and call on accrediting agencies, residency programs, and medical schools to invest in strategies that sustain student and resident interest in primary care.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To speak with corresponding author Christine Laine, MD, MPH, please email Angela Collom at acollom@acponline.org.

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Also new this issue:

Integrating Planetary Health in Health Guidelines (GRADE Guidance 46)

Thomas Piggott, MD, PhD, et al.

Special Article: Research and Reporting Methods

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04761

Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-26-01263

Giant Cell Arteritis

Tanaz A. Kermani, MD, MS

In the Clinic

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-26-00531