Navigation Links
Studies lend insights into colorectal cancer screening
Date:10/1/2007

Philadelphia, PA, October 1, 2007 Two studies in the October issue of the journal Gastroenterology may help in refining recommendations for the use of colonoscopy to screen for colorectal cancer.

One study reports that patients with large polyps or adenomaspre-cancerous growths that may develop into colorectal cancerson initial colonoscopy may need more frequent follow-up, while those with only a few small polyps can be screened less often. The second study suggests that relatives of patients with large polyps should also be targeted for screening.

Dr. David A. Lieberman and colleagues of the Department of Veterans Affairs (VA) Medical Centers in Portland, Ore., compared the results of follow-up colonoscopy in two groups of patients. One group of 895 patients had some type of colorectal neoplasiapolyps or cancersdetected on their initial colonoscopy. The other 298 patients had no polyps or cancers.

When colonoscopy was repeated five years later, advanced polyps or cancers were found in approximately seven percent of the patients with previous polyps, compared to two percent of those without previous polyps.

The "more severe" the abnormalities at initial colonoscopy, the greater the likelihood of detecting large polyps (ten millimeters or larger) or cancers at follow-up. The risk was five times higher for patients with three or more small polyps and six to seven times higher for those who had large polyps or polyps with certain pre-cancerous changes (villous adenoma or high-grade dysplasia). For patients with one or two small polyps, there was no significant increase in risk.

The second study, led by Vanessa Cottet, M.Sc., of Universit de Bourgogne, France, asked whether family members of patients with large polyps were more likely to have abnormal results on colonoscopy. Large polyps or colorectal cancers were found in about eight percent of 168 first-degree relativesparents, children, or siblingsof patients with large polyps. This was twice as high as the rate of abnormalities in a group of 307 patients undergoing colonoscopy for other reasons.

For the family members, risk was even higher when the original patient was male, less than 60 years old, or had polyps located deeper (more distal) in the colon. "[T]here is now evidence to suggest that first-degree relatives of patients with large adenomas may need to be screened and monitored as carefully as relatives of patients with colorectal cancer," the authors suggest. In contrast, the likelihood of finding smaller polyps was no higher for relatives versus comparison patients.

The studies may help efforts to refine the recommendations for screening colonoscopy. "If we know more about risk factors for advanced neoplasia and could electively stratify risk, then screening could be tailoredthat is, targeted to persons with high risk and away from those with low risk, who could either be examined with less invasive methods or perhaps not at all," writes Dr. Thomas F. Imperiale of Indiana University in an accompanying editorial.

Of more than 14 million colonoscopies performed in 2002 in the United States, about 40 percent were for screening while more than 20 percent were for follow-up of patients with previous suspicious polyps or colorectal cancer. Although colonoscopy is a powerful tool for screening, diagnosis, and management, it is a limited resource, according to Dr. Imperiale's editorial. If colonoscopy is not properly allocated, some patients may receive no colorectal cancer screening at all.

The results of the VA study support current recommendations for follow-up colonoscopy in patients with large polyps and other advanced neoplasia. Depending on the size, type, and number of polyps, screening may need to be performed every three yearscompared to every year for patients with colorectal cancer and every five to ten years for those with no abnormalities. In contrast, patients with only one or two small polyps may be treated nearly the same as those with no polyps.

The results of the family study may help in deciding when to screen patients with a family history of large polyps. The researchers emphasize the need for further studies to determine the best approach to screening in relatives of patients with colorectal neoplasia, including possible alternatives to colonoscopy.


'/>"/>

Contact: Jayne Dawkins
ja.dawkins@elsevier.com
215-239-3674
Elsevier
Source:Eurekalert

Related medicine news :

1. Studies On Hearing Loss Discovers New Causes
2. Broccoli Found to Block Cancer Progression In Both Animal and Human Studies
3. Studies Advocate Natural Form Of Vitamin E
4. Cure For Autism Could Be Established Through Hamster Studies
5. Despite More Studies Researchers Are Still Confound With ADHD
6. Studies Show Brain becomes Less Specialized With Age
7. ISB To Establish Research Chair On Real Estate And Urban Studies
8. Studies Show Combination Drugs As A Poor Substitute For Anti-Coagulants In Stroke
9. Further Studies Needed To Completely Understand About Ventricular Fibrillation
10. Studies Report Mammograms Unsafe
11. Six Indians Win Australian Studies Fellowships
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , ... Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. , ... our new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First ...
(Date:6/25/2016)... ... 25, 2016 , ... Dr. Calvin Johnson has dedicated his ... implemented orthobiologic procedures as a method for treating his patients. The procedure is ... to perform the treatment. Orthobiologics are substances that orthopaedic surgeons use to help ...
(Date:6/25/2016)... , ... June 25, 2016 , ... Conventional wisdom preaches ... success. In terms of the latter, setting the bar too high can result in ... than just slow progress toward their goal. , Research from PsychTests.com ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Those who have ... these feelings, many turn to unhealthy avenues, such as drug or alcohol abuse, as ... Michigan, has released tools for healthy coping following a traumatic event. , Trauma sufferers ...
(Date:6/24/2016)... ... , ... Marcy was in a crisis. Her son James, eight, was out of control. Prone ... physically. , “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If ... at my other children and say he was going to kill them. If we ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... LAS VEGAS , June 26, 2016 ... movement to value-based care operating models within the health ... that enable greater financial efficiency , Deloitte offers ... address the key business issues impacting efficient cost optimization: ... alignment , These services facilitate better outcomes and ...
(Date:6/24/2016)... June 24, 2016 ... announced the addition of the " Global Markets ... This report focuses ... an updated review, including its applications in various applications. ... market, which includes three main industries: pharmaceutical and biotechnology, ...
(Date:6/24/2016)... 24, 2016 Research and Markets has ... Companion Diagnostic Tests" report to their offering. ... Diagnostics The World Market for Companion Diagnostics ... diagnostics. Market analysis in the report includes the following: ... Vitro Diagnostic Kits) by Region (N. America, EU, ROW), 2015-2020 ...
Breaking Medicine Technology: