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Colon Cancer Screening Reduces Deaths

Study data support regular assessments (September 19)

Two new studies published in the New England Journal of Medicine provide evidence that regular screening for colon cancer has long-term benefits.

In one study, testing for blood in the stool reduced the risk of death from colorectal cancer by 32% and appeared to keep the death rate low after testing stopped.

In this trial, a total of 46,551 participants, 50 to 80 years of age, in the Minnesota Colon Cancer Control Study were randomly assigned to receive usual care (control) or to undergo annual or biennial screening with fecal occult-blood testing.

Screening reduced colorectal cancer mortality (relative risk [RR] with annual screening, 0.68; RR with biennial screening, 0.78) through 30 years of follow-up. The reduction in mortality was larger for men than for women in the biennial-screening group (P = 0.04).

In the second study, regular colonoscopy was associated with a 68% reduction in the risk of death from colorectal cancer. The findings also confirmed that, if no growths are found, people can safely wait 10 years for their next test.

In this study, researchers examined the association of lower endoscopy (updated biennially from 1988 through 2008) with the incidence of colorectal cancer (through June 2010) and colorectal cancer mortality (through June 2012) among a total of 88,902 participants in the Nurses’ Health Study and in the Health Professionals Follow-up Study.

Over 22 years of follow-up, multivariate hazard ratios (HRs) for death from colorectal cancer were 0.32 after screening colonoscopy and 0.59 after screening sigmoidoscopy. Reduced mortality from proximal colon cancer was observed after screening colonoscopy (multivariate HR, 0.47), but not after sigmoidoscopy.

“These studies don’t break new ground, but they put us on more solid footing in recommending colorectal cancer screening by the current methods and, in general, at the current intervals,” said Dr. Greg Enders, a gastroenterologist at Fox Chase Cancer Center in Philadelphia.

Sources: NEJM; September 19, 2013; NEJM; September 19, 2013; and Reuters; September 18, 2013.

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