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New research identifies more effective tools for detection of colorectal cancer
Date:6/1/2009

o undergo multiple repeat colonoscopies after removal of pre-malignant polyps, some of these patients might have a risk of colon cancer that is no greater than the general population after two colonoscopies. This study found that patients with consecutive colonoscopies performed at least three years apart, with at least one being free of tubular adenomas (the most common type of premalignant polyp), are at very low risk of developing colon cancer after a second colonoscopy.

Current guidelines usually call for repeat colonoscopy anywhere from three to five years after removal of premalignant polyps, based on the number, size and microscopic description of the polyps removed. Depending on results of the second colonoscopy, a third is recommended after another three to five years despite a small body of evidence supporting this practice.

"This is problematic because as more of our resources are dedicated to these repeat colonoscopies, more resources are diverted away from our goal of screening the entire population over 50," said Jonathan Mellen, MD, gastroenterology fellow, Phoenix VA Health Care System. "These findings could help reduce the number of unnecessary colonoscopies, and therefore facilitate more opportunity to perform screening exams. The overall goal is to create a more efficient way to prevent colorectal cancer with reasonable use of our resources."

Investigators sought to determine the value of performing a third colonoscopy on a patient who had already undergone two previous exams. They reviewed endoscopic data from more than 25,000 colonoscopy reports; patients were included if they had undergone at least three colonoscopies, with a three year interval between exams. A total of 154 patients were included, and these patients were grouped according to whether they had pre-malignant polyps removed during the first two colonoscopies.

Results found that patients who had pre-malignant adenomas removed during both the f
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Contact: Aimee Frank
newsroom@gastro.org
301-941-2620
American Gastroenterological Association
Source:Eurekalert

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