Public Release:  Study confirms colonoscopy associated with reduced colorectal cancer incidence

Incidence reduction in the proximal colon differs in magnitude and timing

American Gastroenterological Association

Bethesda, MD (Oct. 1, 2008) - Patients who undergo a complete negative colonoscopy have a reduced incidence of colorectal cancer, confirms a study published in Clinical Gastroenterology and Hepatology. However, in the proximal colon, the incidence reduction of colorectal cancer following complete negative colonoscopy differs in magnitude and timing. The reduction of colorectal cancer is observed in about half of the 14 follow-up years and for the most part occurs after just seven years of follow-up. Clinical Gastroenterology and Hepatology is the official journal of the American Gastroenterological Association (AGA) Institute.

"Our study raises a question about the effectiveness of colonoscopy in usual clinical practice," said Linda Rabeneck, MD, MPH, of the University of Toronto and Institute for Clinical Evaluative Sciences in Toronto and lead author of the study. "Our findings suggest that the effectiveness of colonoscopy is reduced for cancers arising in the proximal colon. Whether this is due to colonoscopy quality, or whether it is due to tumor biology is the key issue that we need to address."

Findings

The relative rate of colorectal cancer overall and the relative rate of distal (left-sided) colorectal cancer in the study group remained significantly lower than the control population. The relative rate of proximal (right-sided) colorectal cancer was significantly lower than the control population in half of the follow-up years, mainly after seven years of follow-up.

Study Design

Using linked administrative databases, researchers identified a cohort of 110,402 Ontario residents aged 50 to 80 years old who had a negative complete colonoscopy between Jan. 1, 1992 and Dec. 31, 1997. Cohort members had no prior history of colorectal cancer, inflammatory bowel disease or recent colonic resection. Each individual was followed through Dec. 31, 2005 and the relative rate of overall colorectal cancer, distal colorectal cancer and proximal colorectal cancer was compared with the remaining Ontario population.

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About Colorectal Cancer

While the incidence of colorectal cancer has declined in recent years, more than 153,000 people in the U.S. will be diagnosed with this cancer and more than 52,000 will die from the preventable disease. Americans have a 6 percent lifetime risk of colorectal cancer, which is the second leading cause of cancer death. When diagnosed early, colorectal cancer patients have a five-year survival rate of about 90 percent; however, fewer than 40 percent of patients present at an early stage.

To find more information about colorectal cancer and colonoscopies and locate a gastroenterologist in their area, patients can visit www.gastro.org/patient.

About the AGA Institute

The American Gastroenterological Association (AGA) is dedicated to the mission of advancing the science and practice of gastroenterology. Founded in 1897, the AGA is one of the oldest medical-specialty societies in the U.S. Comprised of two non-profit organizations--the AGA and the AGA Institute--our more than 16,000 members include physicians and scientists who research, diagnose and treat disorders of the gastrointestinal tract and liver. The AGA, a 501(c6) organization, administers all membership and public policy activities, while the AGA Institute, a 501(c3) organization, runs the organization's practice, research and educational programs. On a monthly basis, the AGA Institute publishes two highly respected journals, Gastroenterology and Clinical Gastroenterology and Hepatology. The organization's annual meeting is Digestive Disease Week®, which is held each May and is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. For more information, please visit www.gastro.org.

About Clinical Gastroenterology and Hepatology

The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit www.cghjournal.org.

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