New study questions the effectiveness of colonoscopies

By Brenda Goodman, CNN Colonoscopies are a dreaded rite of passage for many middle-age adults. The promise has been that if you endure the awkwardness and invasiveness of having a camera travel the length of your large intestine once every decade after age 45, you have the best chance of catching -- and perhaps preventing -- colorectal cancer. It's the second most common cause of cancer death in the United States. Some 15 million colonoscopies are performed in the US each year.

But as a researcher, he has to follow the science,"so I think we have to embrace it," he said."And we may have oversold the message for the last 10 years or so, and we have to wind it back a little." Based on his results, then, he expects that screening colonoscopy probably reduces a person's chances of colorectal cancer by 18% to 31%, and their risk of death from 0% to as much as 50%.Other studies have estimated larger benefits for colonoscopies, reporting that these procedures could reduce the risk of dying of colorectal cancer by as much as 68%.

These studies can be subject to bias, however, so scientists look to randomized trials that blindly sort people into two groups: those who are assigned to get an intervention, and those who are not. These studies then follow both groups forward in time to see if there are differences. Those studies have been difficult to do for colon cancer, which can be slow growing and may take years to be diagnosed.

"I don't think anyone should be canceling their colonoscopy," said Dr. Jason Dominitz is the national director of gastroenterology for the Veterans Health Administration. Polyps are benign growths that can turn into cancers. They are typically removed when identified during a screening colonoscopy, which can lower a person's risk of colorectal cancer in the future.

"They don't see the public service announcements. They don't hear Katie Couric talking about getting screened for colon cancer. They don't see the billboards in the airport and whatnot," he said."So an invitation to be screened in Europe is, I think, likely to be somewhat different than an invitation to be screened in the US."

Source: Healthcare Press (healthcarepress.net)

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