Navigation Links
Pitt researchers raise concern over frequency of surveillance colonoscopy
Date:1/14/2010

PITTSBURGH, Jan. 14 How often patients receive surveillance colonoscopy may need to be better aligned with their risks for colorectal cancer, according to two papers published this month by University of Pittsburgh School of Medicine researchers. The studies provide evidence that colonoscopy is both overused and underused in particular patient populations with serious implications for health care spending.

According to Robert E. Schoen, M.D., M.P.H., professor of medicine and epidemiology at the University of Pittsburgh and senior author of both papers, surveillance colonoscopy is performed to monitor patients who have had precancerous polyps, called adenomas, found on a previous colonoscopy. The aim of surveillance is to identify and remove recurrent growths before they advance to cancer.

"Guidelines recommend that patients who have had pre-cancerous lesions, especially advanced precancerous lesions, get follow-up colonoscopy earlier and more often than patients who do not have polyps," said Dr. Schoen. "Yet our studies show surveillance colonoscopy is not being used by the medical system in relation to underlying risk."

The first study, published in the January edition of the journal Gastroenterology, demonstrates a substantial overuse of surveillance colonoscopy among low-risk patients and under-use among high risk patients. The study followed 3,600 patients from the National Cancer Institute (NCI)-sponsored Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial. Among 1,026 patients with no precancerous lesions at their initial examination, 58 percent underwent a follow-up exam an average of every 3.9 years, although the recommendation would be to do so every five or 10 years. Detailed review of the records could not identify medical reasons for the premature testing. After five years, only 58.4 percent of patients with advanced precancerous lesions received surveillance colonoscopy despite the recommendation that they do so every three years.

"High-risk patients aren't receiving timely follow-up colonoscopy but there is over-utilization among low-risk patients who are unlikely to develop colon cancer," Dr. Schoen said. "This misuse wastes health care resources and risks development of cancers in high-risk patients that might have been preventable." The second study, published in the January issue of GIE: Gastrointestinal Endoscopy, emphasizes a persistent, ongoing risk of cancer, despite colonoscopy, especially among patients with a history of advanced precancerous lesions.

For the study, 1,297 individuals who participated in the NCI's Polyp Prevention Trial, a four-year study which examined the effect of a low-fat, high-fiber, high-fruit and vegetable diet on precancerous polyp recurrence, were followed for an additional six years. Nine cases of colorectal cancer developed although the individuals had multiple colonoscopies during the 10-year observation period. Seven out of the nine subjects who developed cancer had a history of advanced precancerous lesions.

"Despite regular colonoscopy, colorectal cancer may still occur. This study emphasizes that patients with a history of advanced polyps are at particular risk and should be monitored closely with timely surveillance examinations," said Dr. Schoen. "Combined, these studies seriously indicate how surveillance colonoscopy is being implemented, and represent a call-to-action to align colonoscopy use with patient risk, especially in an era where we are trying to spend our health care dollars as effectively as possible."


'/>"/>

Contact: Courtney McCrimmon
McCrimmonCP@upmc.edu
412-586-9773
University of Pittsburgh Schools of the Health Sciences
Source:Eurekalert

Related medicine news :

1. Stress triggers tumor formation, Yale researchers find
2. Johns Hopkins researchers say vaccine appears to mop up leukemia cells Gleevec leaves behind
3. St. Johns wort not helpful treatment for irritable bowel syndrome, Mayo Clinic researchers say
4. Young hunters most likely to be injured using tree stands, say UAB researchers
5. Researchers find clues to why some continue to eat when full
6. Researchers find new patterns in H1N1 deaths
7. Researchers discover gene therapy to prevent progression of emphysema
8. Researchers at the John Theurer Cancer Center Present Cutting-Edge Research Results at this Years American Society of Hematology Annual Meeting
9. Vision researchers Jay and Maureen Neitz to receive first Pepose Award from Brandeis
10. Umbilical cord could be new source of plentiful stem cells, say Pitt researchers
11. Researchers discover novel method for detecting MIRCERA
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/20/2017)... ... ... As a leading dental practice, Wall Centre Dental supports Stroke Awareness Month ... bleeding gums in Vancouver, BC, may be developing gingivitis, the first stage of ... and diabetes. Drs. Parviz Roshan, Siamak Tehrani and Milton Reskovich offer laser gum therapy ...
(Date:6/20/2017)... ... June 20, 2017 , ... This year, participants in the ... finding product improvements that could reduce the occurrence of unplanned extubations (UEs). ... breathing or to provide medication. Sometimes, patient movement can cause unplanned extubations which ...
(Date:6/20/2017)... ... June 20, 2017 , ... Uniform Advantage ... featuring seven new products designed to create tailored looks and athleisure-inspired outfits. UA Flex ... cotton easy care stretch twill. , With trendy looks hitting the medical community, UA ...
(Date:6/20/2017)... ... , ... John D'Eri, CEO of Rising Tide Car Wash , will ... during the Autism Society of America 's 49th annual conference to be held ... (DJFF) was founded in 2002 as the nation's first autism organization focused exclusively ...
(Date:6/20/2017)... ... June 20, 2017 , ... International water ... The Sharon Kleyne Hour Power of Water, Global Climate Change and Your Health ... world’s water crisis and how it affects the human eyes. , According ...
Breaking Medicine News(10 mins):
(Date:6/9/2017)... , June 9, 2017 AirXpanders, Inc. ... focused on the design, manufacture, sale and distribution of ... on the progress of its commercial roll-out in ... available in more than one hundred (100) medical institutions ... AeroForm offers a needle-free alternative for women who ...
(Date:6/7/2017)... -- Endo International plc (NASDAQ: ENDP ) ... Joseph R. Goodwin , U.S. District Court Judge for ... , entered a case management order in MDL 2325, ... Litigation (the "MDL") that includes a provision requiring plaintiffs ... on specific causation within one hundred twenty (120) days ...
(Date:6/3/2017)... June 3, 2017  Eli Lilly and Company ... results from the Phase 3 MONARCH 2 study ... 6 inhibitor, in combination with fulvestrant, significantly improved ... alone in women with hormone-receptor-positive (HR+), human epidermal ... who have relapsed or progressed after endocrine therapy ...
Breaking Medicine Technology: