Colon cancer screening every 15 years may be safe for some people

Fara and his colleagues leveraged several large health and population databases in Sweden to scrutinize cancer outcomes over nearly 30 years.

The researchers' goal was to compare people with no family history of colorectal cancer and a negative initial colonoscopy to people who had never had a colorectal cancer outcome.

The study included a cohort of more than 110,000 Swedish adults, nearly 60% of whom were women, who underwent a first colonoscopy between 1990 and 2016. The average age of the participants was 59 years. In addition, participants inflammatory bowel diseasedocumented Colorectal cancer risk factors.

Members of this group were then compared to members of a control group who did not undergo a colonoscopy to compare the results.

The researchers focused on two things in particular: the 10-year standardized morbidity rate and the 10-year standardized mortality rate. This means the prevalence of colorectal cancer (incidence) in a population and how often deaths related to colorectal cancer (mortality rate) occur.

They found that the group whose initial colonoscopy was negative had a “significantly lower risk” of developing and dying from colorectal cancer over the next 10 years. Their findings allowed him to further extend the standard interval of 10 years for colonoscopies, and in this healthy population he concluded that a 15-year interval was sufficient.

“If we waited 15 years instead of 10 for a second colonoscopy in this population, we might only miss 2 additional cases of colorectal cancer and 1 colorectal cancer death per 1,000 people. “However, this would significantly reduce the number of unnecessary colonoscopies, with about one test per person required.”

If you're reading this and wondering why doctors would suggest reducing the number of colorectal cancer screenings instead of increasing them, that's a valid question. As with any type of medical procedure, colorectal cancer screening and colonoscopy have risks and benefits that need to be evaluated.

“Ultimately, the review of recommendations is a value judgment that society makes. What is an acceptable risk under the CRC? [colorectal cancer] What diagnostic and mortality rates justify extending the interval between colonoscopies and reducing inconvenience costs? I don't think there is ever really a right or wrong answer. ” Dr. Christopher Chen, He is an assistant professor of oncology and director of early drug development at the Stanford Cancer Institute at the Stanford School of Medicine, told Healthline. Chen was not involved in this research.

Redefining goals Colorectal cancer screening recommendations We aim to reduce the potential harms of unnecessary colonoscopies while maximizing the benefits of early cancer detection.

Because of the potential harms of colonoscopies, there is a legitimate concern about having colonoscopies less frequently. In addition to the burden of having to schedule, prepare, and pay for a colonoscopy, you may also: physical harmAlthough unlikely, it could happen. Bleeding and perforation are the most common complications of colonoscopy. Perforations occur in approximately 3 out of 10,000 cases.

“Obviously, it's not a trivial issue,” Chen said.

“First of all, there's the risk of injury from the procedure. Then there's the cost to society. Additional colonoscopies cost a lot of money,” Ness added.

People with negative colorectal cancer colonoscopy results and no family history of colorectal cancer may have to wait 15 years for their next screening, a new Swedish population-based study concludes.

This finding adds an additional 5 years to the standard recommended 10-year screening interval.

But experts caution that the findings may not be generalizable to more diverse populations, such as those in the United States.