Navigation Links
Repeat Colonoscopies Underused in High-Risk Patients
Date:5/20/2008

Other research found traditional colonoscopy still better than virtual version

TUESDAY, May 20 (HealthDay News) -- The people who most need to have repeat colonoscopies to detect precancerous growths are less likely to get the potentially lifesaving procedures, new research shows.

"We are doing more colonoscopies among the low-risk groups and not enough among the high-risk," study author Dr. Adeyinka Laiyemo, a cancer prevention research fellow at the National Cancer Institute, said during a press conference Monday at Digestive Disease Week 2008 in San Diego.

In a colonoscopy, a thin, lighted flexible tube with a tiny video camera is eased into the colon and a tiny camera transmits pictures to a TV screen. Small air puffs put into the colon keep it open and allow the doctor to see it clearly.

Laiyemo reported on the follow-up to the Polyp Prevention Trial, in which his team continued to follow those participants after the trial ended. The original trial was a four-year study in which some patients were randomly assigned to eat a low-fat, high-fiber diet with plenty of fruits and vegetables to see if it would prevent the recurrence of polyps, growths that can develop into colon cancers.

Of the 2,079 enrolled in the trial, 92 percent finished it, having an average of 3.1 colonoscopies, procedures that can detect colon cancer in early and curable stages. Of those, 1,297 patients agreed to be followed up by providing their subsequent colonoscopy reports.

During the six or more years of follow-up, 774 had repeat procedures. But while 30 percent of the patients termed low-risk (because they had a low risk of polyps at the end of the trial), just 41 percent of those classified as high risk of recurrence had repeat colonoscopies.

A second study, also presented at the conference, continues to support colonoscopy as the first line of detection for polyps. "The bigger the polyp, the greater the chance [the colon] has cancer already or it is going to turn into it," said Dr. Douglas Rex, a professor of medicine at Indiana University School of Medicine and director of endoscopy at Indiana University Hospital, in Indianapolis.

In his study, Rex wanted to evaluate the impact of a new recommendation from the American College of Radiology, recommending that polyps 5 millimeters or smaller not be reported on CT colonography (CTC), also called virtual colonoscopy, a procedure in which a detailed picture of the colon is created by an X-ray machine linked to a computer. The recommendation also suggests those with one or two polyps that are 6 millimeters to 9 millimeters be offered CTC surveillance in three years instead of polyp removal.

Rex's team looked at more than 10,000 polyps over a five-year period after they had colonoscopies. They wanted to figure out how many patients would have been identified as higher risk if they had CTC as their first test instead of colonoscopy, doing so by evaluating the numbers and sizes of polyps.

If CTC had been used as the first test, and if the CTC had been 100 percent accurate at finding polyps over 5 millimeters, then 29 percent of all the patients and 30 percent of those over age 50 with high-risk polyps would have been classified as normal, he said.

In another presentation, the shorter the interval between completing the bowel cleaning preparation required before colonoscopy and the start of the procedure, the better.

"Colonoscopy started within 14 hours of the last preparation had better quality," said study author Dr. Ali Siddiqui, an assistant professor of internal medicine at the University of Texas Southwestern Medical Center at Dallas.

His team gathered information over a three-month period on 378 outpatients who had colonoscopies done at a VA Medical Center.

The American Cancer Society expects more than 108,000 cases of colon cancer diagnoses this year, plus another 40,000 cases of rectal cancer. Almost 50,000 people in the United States will die of colorectal cancer this year, the society estimates.

More information

For more on colonoscopies, go to the National Institute of Diabetes and Digestive and Kidney Diseases.



SOURCES: May 19, 2008, teleconference with Adeyinka O. Laiyemo, M.D., Cancer Prevention Fellow, National Cancer Institute, Bethesda, Md.; Douglas Rex, M.D., professor, medicine, Indiana University School of Medicine, and director, endoscopy, Indiana University Hospital, Indianapolis; Ali Siddiqui, M.D., assistant professor, internal medicine, University of Texas Southwestern Medical Center at Dallas; May 19, 2008, presentations, Digestive Diseases Week 2008, San Diego


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Repeat steroids to premature infants linked to cerebral palsy
2. National Energy Services Receives Repeat Orders From Golden Living and Cathedral Rock Skilled Nursing Facilities
3. UP Repeats NCQA Certification in Utilization Management
4. Abnormal glutamine repeats interfere with key transcription factor, leading to neurodegeneration
5. Home Oxygen Care Leaders Say Presidents Budget Will Lead to Significant Patient Service Disruptions, Call for Thoughtful Reforms as Opposed to Repeated Cuts
6. Ignition Locks Prevent Repeat DWI Offenses
7. Blood Clots in Legs, Lungs Predispose Patients to Repeat Episodes
8. AUDIO from Medialink and the Anxiety Disorders Association of America: Treat It, Dont Repeat It: Break Free from OCD
9. Repeat Colonscopies Underused in High-Risk Patients
10. Penn research offers road map to safer pain control, cost savings during colonoscopies
11. High-Risk Blacks Less Likely to Get Colonoscopies
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Repeat Colonoscopies Underused in High-Risk Patients
(Date:4/29/2016)... ... April 29, 2016 , ... Our bodies are bombarded ... to confront and deal with these stressors is to adopt a more healthful diet, ... for you. Risa Groux, a certified Holistic Nutritionist and the creator of the Newport ...
(Date:4/29/2016)... ... April 29, 2016 , ... The American workforce is ... even security. Most importantly, employees are the single most important asset in creating ... so unhappy? , Just under half of American workers are emotionally checked out ...
(Date:4/29/2016)... (PRWEB) , ... April 29, 2016 , ... ... student loans more flexibility in repaying their loans, more information about their loan ... time when total outstanding student loan debt, including federal and private loans, has ...
(Date:4/29/2016)... ... April 29, 2016 , ... Coast Dental Fort Stewart ... at its new location in the Exchange Furniture Mall at 112 Vilseck Road in ... 50-inch Samsung Smart TV. Plus attendees will have the opportunity to meet general dentists ...
(Date:4/29/2016)... ... April 29, 2016 , ... Spine Team Texas, a comprehensive spine physician group ... of their physicians has been invited to be a featured speaker at the Texas ... conference on April 30, 2016. , Dr. R. Scott McPherson, a physical medicine ...
Breaking Medicine News(10 mins):
(Date:4/28/2016)... Calif. , April 28, 2016  Marking ... widely accessible breast and ovarian cancer risk test, ... panel analyzing 30 genes that highly impact the ... women. Available today, the Color Test analyzes hereditary ... prostate, stomach, and uterine cancers. The Color Test ...
(Date:4/28/2016)... Dr. Vivek Ahuja , George ... phen Schmidt Join the Growing Organization ... for life sciences, today announced key new leaders have joined the ... a growing business.  This will bolster the company,s safety business unit ... ArisGlobal in the position of Vice President - Safety. George has ...
(Date:4/28/2016)... 2016 New market research ... a report that provides an overview of the ... by identifying new targets and MOAs to produce ... discussed in this H1 2016 Osteoarthritis Pipeline report ... Inc., Abiogen Pharma S.p.A., Ablynx NV, Achelios Therapeutics, ...
Breaking Medicine Technology: