The study focused on the rate of interval colorectal cancer in patients participating in the Polyp Prevention Trial Continued Follow-up Study, a four-year multicenter, randomized, controlled trial designed to examine the effects of a low-fat, high-fiber, high-fruit and vegetable diet on the recurrence of colorectal adenomas, or precancerous polyps. The University of Pittsburg study on the occurrence of interval colorectal cancer appears in the January issue of GIE: Gastrointestinal Endoscopy, the monthly scientific journal of the American Society for Gastrointestinal Endoscopy.

“Despite regular colonoscopy, interval colorectal cancer may occur,” says study lead author Robert E. Schoen. “We set out to examine the rate at which these interval cancers appear.”

The study found that nine cases of colorectal cancer were diagnosed over 7,626 person-years of observation, or a rate of 1.2 per 1,000 person-years of observation. In patients involved in the study who developed colorectal cancer, 78 percent had a history of precancerous polyps. The majority – about 78 percent – were detected at an early stage and thus were considered highly curable.

Colonoscopies are the “gold standard” for detection of colorectal cancer. Screenings are recommended for all individuals beginning at age 50 or earlier for people with a history of colorectal cancer or who are exhibiting symptoms such as blood in the stool. During colonoscopy exams, doctors can detect and remove polyps, some of which can become cancerous if not removed.

SOURCE: Fleet Attorney › Study shows need for thorough polyp removal, continued surveillance

Doctors have been working to improve the technology used during the screening, and according to reports at the annual meeting, their efforts have paid off. One improvement is a disposable device that is passed through the instrument channel of a standard colonoscope, called a Third Eye Retroscope, or TER. The scopes let doctors get a better view of the areas they may otherwise miss with standard screening equipment.

Studies on the use of TER have found the new technique gave doctors 13 percent improved diagnostic yield. In the study of 300 patients, researchers concluded that 15 of 136 precancerous growths and 34 of 257 polyps would have been missed had it not been for the TER.

Another plus is high-definition technology in colonoscopies are giving doctors an even better view of the colon than traditional “white light” colonoscopies. One study included 2,400 patients, half of whom underwent standard exams while the other half had high-definition exams. Thirty percent of precancerous lesions were found in the high-def group compared to 24 in the standard-def group. High-definition is not available at all facilities but should become more widely available as facilities upgrade to newer machines.

SOURCE: Fleet Attorney › Advances in technology improve accuracy of colonoscopies

Colorectal cancer is the third most common cancer diagnosed in both men and women and the second leading cause of cancer-related deaths among men and women combined in the United States, according to the American Cancer Society. The lifetime risk of developing colorectal cancer is about 1 in 19. Currently, the best defense against colorectal cancer is routine colonoscopies.

While colonoscopies carry few risks, the elderly do experience a higher percentage of complications from the procedure. Preparing for the colonoscopy may also present problems for some patients. Earlier this year the Food and Drug Administration (FDA) placed a black box warning – its strongest warning possible – on prescription oral sodium phosphate (OSP) products used to cleanse the bowel prior to colonoscopy, Visicol and Osmo Prep. The products have been associated with a rare kidney injury known as acute phosphate nephropathy.

The same concern was placed on over-the-counter OSP products such as those made by Fleet. The FDA warning prompted Fleet to remove its OSP products from store shelves.

Source: Technology Review

SOURCE: Fleet Attorney › Vaccine may eliminate need for routine colon screenings