Beasley, Allen, Crow, Methvin, Portis & Miles, P.C.

People considered “low risk” for colorectal cancer are having too many colonoscopies, and not enough patients considered “high risk” for the disease are having timely follow-up procedures, according to researchers with the University of Pittsburgh School of Medicine.

There is no debate that colonoscopies are vital for the early detection and treatment of cancers of the colon and rectum. Colorectal cancer is the third most deadly cancer among American men and women. The American Cancer Society recommends people begin regular colon screenings at age 50 or earlier if they have a family history of the disease or are presenting bothersome symptoms.

But the procedure is no cakewalk. It involves a one- to two-day prep of cleansing the bowel with a laxative solution that can make patients sick, if not uncomfortable. For the procedure, patients are sedated and a surgeon runs a thin, flexible scope into the colon to look for signs of cancer or polyps, which can be immediately removed.

Because of the uncomfortable nature of the exam, doctors worry that too few people actually have colonoscopies. And those who require follow-up exams may be less inclined to go.

Researchers analyzed data from 3,627 participants in a National Cancer Institute-sponsored trial and found “significant underuse” of surveillance colonoscopy among those considered high-risk for colorectal cancer. Within five years of an initial colonoscopy, only 58.3 percent of patients with advanced precancerous growths had a follow-up colonoscopy, which is typically recommended every three year for such patients.

But even more surprising, researchers also found what they called “substantial overuse” of surveillance colonoscopies among people considered low-risk for colorectal cancer.

“This is a clear example of an intervention not being utilized in relation to the risk,” said Dr. Robert Schoen, senior investigator of the study. The report appears in the latest issue of the journal Gastroenterology.

Source: Reuters

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