Support for colon cancer screening even stronger

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In the midst of serious questions about the efficacy of certain cancer screenings, it s heartening to finally hear some good news: Colonoscopies really do save lives, according to the results of a new long-term study. In fact, the new findings demonstrated that people who have potentially cancerous growths (polyps) removed as the result of a colonoscopy have a 53 percent lower mortality rate from colorectal cancer (CRC) than that predicted in the general population.

CRC is the second biggest cancer killer in the U.S. (after lung cancer): Over 140,000 cases are diagnosed each year, and over 50,000 people die annually from it. All CRC cases start as precancerous growths, called adenomatous polyps, and if these polyps are removed early enough, the cancer can usually be prevented. A colonoscopy allows a doctor to check directly for these growths in the intestine with a camera and to remove them.

For this study, published in The New England Journal of Medicine, researchers led by a gastroenterologist at the Memorial Sloan-Kettering Cancer Center in New York followed 2,602 patients for up to 23 years. All of the patients had undergone a colonoscopy between 1980 and 1990 and had adenomatous polyps removed. During the subsequent follow-up, the researchers found that there were only 12 CRC deaths among the study population. The number predicted statistically from the American Cancer Society s SEER database was 25, associating the procedure with a 53 percent decrease in CRC mortality.

We always say that CRC screening with colonoscopy is important, notes ACSH s Dr. Gilbert Ross, but this is the first long-term study to show that colonoscopy truly does save lives.

Unfortunately, despite the lifesaving potential of colonoscopies, only about 6 in 10 adults in the U.S. follow the recommended CRC screening guidelines. The procedure is recommended starting around age 50 for the general population, but those with risk factors should be screened earlier and more frequently. Repeat colonoscopies should proceed every 10 years for patients with no polyps, and every three years for patients who do have these growths. If people avoid the procedure, it s often because preparation for it can be unpleasant, involving dietary restrictions for two days, as well as laxatives. Add to that the slight risk of procedural complications, although rare, and the cost of hundreds or thousands of dollars, and it s clear why people tend to drag their feet.

If there were a way to provide this procedure in a less uncomfortable and less expensive manner, this could help improve the rates at which people undergo colonoscopies. We really do have the potential to nearly eradicate CRC deaths, ACSH s Dr. Elizabeth Whelan observes.