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One Colonoscopy Effective In Reducing Cancer Deaths

Just a single colonoscopy could save your life, study suggests

October 16, 2007

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Getting just one colonoscopy might save your life, researchers say.

Using a model to predict reductions in death from colorectal cancer, epidemiologists and clinical researchers from Memorial Sloan-Kettering looked at the relative effect of getting just one screening colonoscopy which cleared pre-cancerous polyps from the colon versus surveillance follow-up colonoscopy.

Ann G. Zauber, Ph.D., Sidney J. Winawer, M.D., MACG and colleagues presented their findings at the Annual Scientific Meeting of the American College of Gastroenterology.

“The model demonstrated a dramatic reduction in expected colorectal cancer mortality with initial polypectomy with or without surveillance, and suggests that the initial polypectomy accounts for the major component of the mortality reduction,” explained Dr. Zauber.

Using a “MISCAN” model, researchers used National Polyp Study data to predict colorectal cancer mortality among three groups of patients: those with no initial removal of polyps or follow-up surveillance by colonoscopy, compared to patients with only initial polypectomy, and those with both polypectomy and follow-up surveillance.

The model predicted mortality of up to thirty years after the initial colorectal exam and removal of pre-cancerous polyps.

According to Zauber, the major effect on colorectal cancer mortality reduction produced by the initial polypectomy rather than the surveillance colonoscopies is consistent with the low incidence of advanced adenomas observed during National Polyp Study (NPS) follow-up (i.e., pre-cancerous growths in the colon larger than 1 cm, polyps with a villous component, high grade dysplasia or invasive colorectal cancer.)

Zauber and her colleagues suggest that these findings may support the recommendation to lengthen the interval to six or more years for follow-up surveillance for patients who have polyps removed.

Current recommendations by the American College of Gastroenterology call for surveillance colonoscopy in three to five years for follow-up of patients with prior colorectal cancer, prior adenomas or disease with causes increased risk of colorectal cancer.

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