From the AMA: A study touting the benefits of colonoscopy received significant coverage, with the findings discussed on two national television news broadcasts, and in several online and print sources. Most sources portrayed the finding as confirmation of the screening tool’s ability to prevent colon cancer deaths, although some experts were skeptical of the findings.
In a front-page story, the New York Times (2/23, A1, Grady, Subscription Publication) reports, “A team of researchers led by Dr. Sidney J. Winawer, a gastroenterologist at Memorial Sloan-Kettering Cancer Center in New York City, followed 2,602 patients who had adenomatous polyps removed during colonoscopies from 1980 to 1990.”
Bloomberg News (2/23, Langreth) reports, “Through the end of 2003, 1,246 of the patients who had adenomas removed had died.” Just “12 of those deaths were from colon cancer, far lower than the 25.4 colon cancer deaths that would have been expected in otherwise similar patients in the general population, according to the study results.”
Blogfinger Medical Commentary. By Paul Goldfinger, MD, FACC
The development of the flexible colonoscope was the Holy Grail for gastroenterologists. Before that, they had no way to directly visualize the interior of the entire colon.
Now, magnificent images are obtained at colonoscopy of the actual interior walls of the large bowel. The quality is so good that an Oscar should be awarded for cinematography in medicine. For the first time, patients could be accurately screened for colon cancers as well as precancerous polyps (adenomas), the latter of which could be snared and removed, providing a diagnostic tool and a treatment combined. Removing the polyp offered the chance to prevent colon cancer, and everyone rejoiced in that advance.
But in medicine, we prefer to know if a treatment not only treats a disease, but actually saves lives. That is the essence of successful preventive medicine at its loftiest.
Believe it or not, despite the colonoscopy juggernaut currently going on, we have not, until now, had proof that preventing colon cancer by this approach would actually save lives— although it seems intuitive that it would. Hats off to those doctors at Sloan Kettering in New York who had the patience (it was a 20 year trial) and the patients (2,602 individuals whose polyps had been removed by colonoscopy) to enable completion of this trial.
Now, in the New England Journal of Medicine (Feb 22, 2012), they have published the result: a 50% reduction in colon cancer mortality. Note that there are some “buts” including the fact that the study did not compare colonoscopy to some other testing techniques, but to most experts, colonoscopy screening is the way to go.
If you are a person who has foolishly ignored the colonoscopy guidelines, perhaps this new research will convince you to call your friendly gastroenterologist and make an appointment now for this potentially lifesaving procedure.