Studies Offer More Evidence That Colonoscopy Saves
WEDNESDAY, Feb. 22 (HealthDay News) -- It's been found that
removing precancerous polyps during colonoscopies can prevent
deadly malignancies from developing. Now, new long-term research
supports the idea that the screening test not only prevents
colorectal cancers, but dramatically cuts deaths from the
Analyzing the results of the National Polyp Study -- which
followed about 2,600 patients whose precancerous polyps were taken
out during colonoscopies for up to 23 years -- researchers from
Memorial Sloan-Kettering Cancer Center in New York City and
colleagues found that this course of action netted a 53 percent
drop in colon and rectal cancer mortality compared to deaths
expected among similar patients in the general population.
"This is very strong evidence that provides assurance that there is a long-term benefit to removing these polyps," said lead author Ann Zauber, a biostatistician at Sloan-Kettering. "Over more than 20 years, we're getting this very consistent decrease in colon cancer deaths, so that's very exciting."
The study is published Feb. 23 in the
New England Journal of Medicine.
In a related study published in the same issue, researchers from
Spain found that fecal immunochemical testing (FIT) -- which uses
stool samples to detect the presence of colorectal cancer --
yielded similar detection rates as colonoscopy in finding cancerous
lesions. However, colonoscopy detected more advanced polyps than
FIT, though more people opted to participate in fecal testing.
Colorectal cancer, the third most common type of malignancy
worldwide, is one of the few cancers that can be prevented when
screening tests are done properly, experts said. But the invasive
and involved nature of colonoscopy -- during which the bowel is
viewed with a camera after a day-long bowel cleanse -- seems to
deter about half of Americans who should be screened from
undergoing the test. The U.S. Preventive Services Task Force
recommends colorectal screening for those between 50 and 75.
"Research like this is still needed because despite all of what we know and recommend, the American people are still not good at getting screening. So we really have a ways to go," said Dr. David Bernstein, chief of the division of gastroenterology at North Shore University Hospital in Manhasset, N.Y. "To me, it's honestly a no-brainer."
The National Polyp Study, which involved seven clinical centers,
also found that patients who had precancerous colon polyps removed
had the same low death rate from colon cancer for up to 10 years
after the procedure when compared to another group of patients in
whom no such polyps were found. Researchers used the U.S. National
Cancer Institute's Surveillance, Epidemiology and End Results
population-based registry program to compare observed death rates
in those with precancerous polyps to a similar group in the general
Meanwhile, the Spanish study, a trial involving more than 50,000
people that is still under way, will compare colorectal cancer
deaths after either one-time colonoscopy screening or FIT screening
every two years for a period of 10 years.
Dr. Anthony Starpoli, a gastroenterologist at Lenox Hill
Hospital in New York City, said the Spanish study drives home the
point that colonoscopy is superior to other types of screenings,
but compliance with all types is low.
"It's easier to do FIT, but it's not a substitute for colonoscopy," he said. "It's a good screening test to do before colonoscopy, or in the interim between colonoscopies . . . but you would be surprised at how many people don't get FIT. It just does not get done."
Starpoli suggested that doctors spend more time explaining
colonoscopy screening to patients instead of "simply mandating they
have a test."
"I think this is the fault of the physicians," he said. "I think it's an education issue, and [these studies] help in the education. It's pretty clear-cut."
The U.S. Centers for Disease Control and Prevention has more on
colorectal cancer screening.
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