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New, large study questions colonoscopy benefits


By Lynn Allison From Newsmax

Colonoscopies have been touted as the gold standard for colorectal cancer screenings. But a new landmark study published Sunday in the New England Journal of Medicine questions their effectiveness in preventing colon cancer and death. The study found only small benefits for the group of study participants invited to get the procedure versus those who didn’t get screened. The results showed a mere 18% lower risk of developing colorectal cancer, and no significant reduction in the risk of cancer death.

Dr. Michael Bretthauer, a gastroenterologist from the University of Oslo in Norway who was one of the study researchers, said he found the results disappointing, according to CNN, adding that “we may have oversold the message (on getting colonoscopies) for the last 10 years or so, and we have to wind it back a little.”

But other experts point out that the limitations of the study likely affected the outcomes. Only 42% or 12,000 out of 28,000 participants invited to get a colonoscopy underwent the procedure. When the researchers restricted their calculations to those who did get colonoscopies, the procedure was found to be more effective. It reduced the risk of colorectal cancer by 31% and cut the mortality risk of dying from that cancer by half.

Bretthauer said that the true benefits of having a colonoscopy probably fall somewhere in between the two measurements. He revealed that screening colonoscopies most likely reduce a person’s chance of colorectal cancer by 18% to 31%, and their risk of death from 0% to 50%.

The NordICC study, which stands for Northern-European Initiative on Colon Cancer, included 84,000 men and women ages 55 to 64, from Poland, Norway, and Sweden. None of the participants had had a screening colonoscopy prior to being invited to have the procedure done between June 2009 and June 2014.

According to CNN, the group who had screening colonoscopies had an 18% lower risk for colorectal cancer than the group who wasn’t screened. The researchers will follow participants for another five years because colon cancers can be slow growing, and more time is needed to assess the results accurately.

Experts warn that the shocking study results should not deter screening.

“I don’t think anyone should be canceling their colonoscopy,” said Dr. Jason Dominitz, the national director of gastroenterology for the Veterans Health Administration. “We know that colon cancer screening works.”

According to STAT, colonoscopies find and identify pre-cancerous polyps called adenomas. After inserting a camera up the patient’s rectum, if the endoscopist discovers a suspicious polyp, it’s promptly removed, before it can turn into cancer. This can reduce a person’s risk of developing colorectal cancer in the future. Past research has shown that colonoscopies could reduce the incidence and mortality from colon cancer by a whopping 70%.

The problem is that none of these studies were large, randomized trials like the one Bretthauer and his colleagues conducted. While the latest results are incongruent with past results, Dominitz says other screening tests have consistently showed a reduction in cancer mortality.

The next step is pitting fecal screening, a less invasive screening tool, against more invasive colonoscopies. Dominitz and others are working on large, randomized trials to test the effectiveness of fecal screening to prevent colorectal cancer and mortality.

“The first message is that screening saves lives and prevents cancer,” says Dr. Samir Gupta, a gastroenterologist at the University of California, San Diego, who was not part of the study. “If we could have a chance to start everyone at 45, I’d like that. Second is you have many options. Someone who says, ‘I am way too busy, I can’t take two days off work for a colonoscopy.’ OK. We have stool-based options.”

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