Some people may be able to wait longer between colonoscopies, study suggests

CNN
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A new study raises the question of whether anyone can wait longer than the recommended 10 years for repeat colonoscopies after an initial negative screening for colorectal cancer. .

Research published in JAMA Internal Medicineexamined 120,000 people aged 65 and over in Germany who underwent colonoscopies more than 10 years after their first negative screening, from 2013 to 2019, and performed on people aged 65 and over during that period. All colonoscopy screenings were compared. It was screened for the first time.

The presence of precancerous or cancerous tumors was 40% to 50% lower among repeaters, in only 4% to 5% of women and 5% to 7% of men more than 10 years after a negative result. An advanced tumor or cancer was found. Colonoscopy.

The researchers also evaluated whether men and women differed in the number of abnormal growths and found a 40% higher prevalence in men.

By age group, the detection rate was highest among those aged 75 and over.

The authors concluded that the current 10-year screening interval for colonoscopies is safe, and extended intervals may be warranted in some cases, especially for women and young people without gastrointestinal symptoms. It also suggests that there is a possibility that

“For example, younger screening-age women with no findings on index colonoscopy may be screened at longer intervals. It may offer less invasive methods such as testing for age,” the study’s authors wrote.

Colorectal cancer is the second leading cause of cancer death in the United States. It is also one of the most preventable cancers due to effective screening tests such as colonoscopies that can detect early disease.

Mortality from colorectal cancer has declined in recent decades, primarily due to colonoscopies.

Current guidelines recommend screening for colorectal cancer in all adults aged 45 to 75 years. In response to more cancers being diagnosed at younger ages, recommendations were recently changed to begin screening at age 45 instead of age 50. If screening is negative, patients are does not require another screening for 10 years.

Douglas Owens, Ph.D., professor of health policy at Stanford University and former chair of the US Preventive Services Task Force for Cancer Screening Recommendations in the United States, says the findings are encouraging.

“[Colorectal cancer]is unlike any other cancer where there is potentially a lot of harm from over-screening. Small here, but not zero. This is from colonoscopies. So if you can get the same benefit with fewer colonoscopies, that’s a win,” Owens said.

Owens, like Dr. Robert Bresalier, a professor of gastrointestinal oncology at MD Anderson Cancer Center, would like to see more research into extending the screening interval.

“There is good evidence that screening colonoscopies at 10-year intervals in asymptomatic individuals is effective and cost-effective. I am not ready to change my practice in terms of increasing intervals based on research, but it is comforting and provides additional data to reinforce the notion of adhering to these guidelines. “The overall message from this study is that we are satisfied with the current guidelines.”

The study authors said the study’s findings do not apply to individuals who need to undergo an early colonoscopy to assess symptoms such as rectal bleeding, or who are at high risk for colorectal cancer. They note that generalizations of findings should be done with caution.

Experts argue that colonoscopies are one of the most important preventative services and that all eligible groups should be tested.

“[This study]supports the importance of screening for colon cancer, and shows that there are many, many effective ways to do it,” Owens said.

Colonoscopy is considered the gold standard for colon cancer screening, but there are alternatives. Other screening options include an annual fecal occult blood test that looks for blood in the stool.

“The main thing is to get screened. It doesn’t matter if you use a stool test or get a colonoscopy. Pick one. Pick the one that suits your taste,” says Owens. said.

More than a quarter of eligible Americans have not been tested for colorectal cancer, and public health advocates are urging Americans to get tested.

“Right now, the biggest impact we can have, and the one that is relevant to this discussion, is screening. And that clearly has a bigger impact and is the biggest impact we can have right now in terms of impacting colorectal cancer deaths.