Evidence That Colonoscopy Reduces Deaths from Colorectal Cancer
Removal of polyps during colonoscopy substantially reduces the risk of death from colorectal cancer, providing further support for use of colonoscopy as a colorectal cancer screening test. These results were published in the New England Journal of Medicine.
Colorectal cancer is the second leading cause of cancer death in theUnited States. For people at average risk of colorectal cancer, the American Cancer Society recommends that routine screening begin at age 50. Recommended options for screening include colonoscopy, sigmoidoscopy, double-contrast barium enema, fecal occult blood tests, fecal immunochemical tests, and stool DNA tests. In addition to detecting cancer at an early stage, colorectal cancer screening can also help to prevent the development of colorectal cancer; some screening tests can identify precancerous polyps that can be removed before they become cancerous.
During a colonoscopy, a flexible tube attached to a camera is inserted through the rectum, allowing physicians to examine the internal lining of the colon and rectum for polyps or other abnormalities. If polyps are identified, they can be removed during the colonoscopy.
Previous studies have indicated that removal of polyps during colonoscopy reduces the occurrence of colorectal cancer. The effect of polyp removal on colorectal cancer deaths, however, has been less certain.
To assess the long-term effects of polyp removal, researchers evaluated information from the National Polyp Study. Information was available about 2,602 people who had precancerous (adenomatous) polyps removed during colonoscopy.
During more than 15 years of follow-up, people who had had colorectal polyps removed during colonoscopy were roughly half as likely to die of colorectal cancer as people in the general population.
Although this study was not a randomized clinical trial (the most definitive type of study), these results provide the best evidence to date that colonoscopy and polyp removal reduce the likelihood of death from colorectal cancer.
Reference: Zauber AG, Winawer SJ, O’Brien MJ et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. New England Journal of Medicine. 2012;366:687-96.
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