Colon screening controversy: Doctors say look at the data and don’t skip out
A new study on colon screenings is creating controversy. This research could have negative health implications. It was welcome news for people who just don’t like the idea of having a colonoscopy. A new study seemingly shows that colon cancer screening is not necessary.
But doctors say not so fast. Looking more closely at the data, experts urge people not to cancel their appointment.
Dr. Salina Lee is a Rush University Medical Center gastroenterologist.
She knows firsthand the screening finds and removes polyps that can develop into cancer. Regular screenings detect cancer early.
“Colorectal cancer at early stages causes no symptoms at all. The most common symptom is nothing,” she said. “Logically you can assume, and it is true, stage for stage, if you can find a cancer early, you can offer better treatment options and cure.”
But a study published in the New England Journal of Medicine called the screening into question. Researchers examined patients from Poland, Norway and Sweden and found the 10-year risk of colon cancer was lower among study participants who underwent colonoscopy but only by 20%, less than prior studies. Study authors say colonoscopy did not significantly reduce cancer death rates.
“What it’s saying is that when you compare groups between patients invited to receive colorectal cancer screening by colonoscopy vs those that were not invited to get screening, there was no significant difference between death from cancer,” Lee said. “That is one of the primary endpoints and it’s a very important endpoint.”
The consensus among U.S doctors is the numbers in this new study are misleading.
Some study patients did not get colonoscopies. Others were invited to undergo the scan, but only 42% actually got a colonoscopy. Yet, information from all of that so-called colonoscopy group was included in the analysis.
“And so when you have a low participation rate that will alter the results,” Lee said. “If you actually look at the effect of patients who underwent the screening colonoscopy, the decrease in the rate of colorectal cancer deaths was by 50%. It was significant if you look at the patients who actually went through the test.”
The patient population is important as well.
“In the United States the demographics, especially in urban centers, is not going to look like what it looks like in Norway Sweden and Poland,” Lee said.
Age is also a factor. This study looked at 55-64 years old, ages too late to begin colon screening for meaningful protection from death. In the U.S., a colonoscopy is recommended at age 45. Doctors say it does save lives.
“Colorectal cancer affects one in every 20 people it is just that common,” Lee said. “It’s the fourth most common cancer worldwide. It is the second leading cause of death.”
The bottom line, doctors say more research is needed since this latest European study is contradictory to what research has shown in the United States for years. Colon screening is impactful for reducing colon cancer deaths. And there are other options now. Discuss them with your doctor, don’t ditch colon screening altogether.
Suggest a Correction