Colonoscopy screening exams that are recommended for older U.S. adults failed to reduce the risk of death from colon cancer in a 10-year study that questions the benefits of the common procedure.
While people who underwent the exam were 18% less likely to develop colon cancer, the overall death rate among screened and unscreened people were the same at about 0.3%, researchers from Poland, Norway and Sweden said Sunday in a study published in the New England Journal of Medicine.
Health experts at the World Health Organization, the U.S. Preventive Services Task Force and other bodies issue recommendations on screening for breast, prostate, colon and other cancers to catch disease in its earliest and most treatable stages. Debate has ensued over the past few years over whether some preventive screenings are helpful in the general population because of possible patient harm and unnecessary treatment, leading to higher health care costs.
“This relatively small reduction in the risk of colorectal cancer and the non-significant reduction in the risk of death are both surprising and disappointing,” Jason Dominitz, a gastroenterologist at the University of Washington School of Medicine, and Douglas Robertson of the Dartmouth Geisel School of Medicine said in an accompanying commentary. “Additional analyses, including longer follow-up and results from other ongoing comparative effectiveness trials, will help us to fully understand the benefits of this test.”
In Georgia, there will be an estimated 4,970 new cases of colorectal cancer diagnosed in 2022 and 1,590 deaths.
Dr. Arif Kamal, chief patient officer for the Atlanta-based American Cancer Society, warns people not to skip getting colonoscopies based on the report. The American Cancer Society recommends regular colon cancer screening begin at age 45 for those at average risk, lowering the age from 50 after noting an increase in these tumors in younger adults.
“The study paints a bit of a confusing picture because it mixes those who are recommended to get a colonoscopy and don’t receive it and those who are recommended and receive it. They have tremendous value if completed.”The bottom line is that it doesn’t change would I would tell a patient today.”
The study highlights the challenges some face in getting the procedure and the need to reduce the barriers to access and payment. Kamal said the ACS recommends that for some, especially those with a family history of colorectal cancer, get screened earlier.
Experts have noticed a “worrisome” trend of African-American men in their 40s who are being diagnosed with colon cancer. “Now is not the time to take our foot off the gas pedal,” Kamal said.
In a colonoscopy, a long, flexible tube with a tiny video camera is threaded through the rectum into the intestine to look for possible cancerous changes. Doctors sometimes remove polyps and other abnormal tissue using the tube during the procedure. Before the pandemic, more than 15 million colonoscopies were performed each year in the U.S., according to the University of Pennsylvania Abramson Cancer Center.
AJC Staff writer Shelia Poole contributed to this report.
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