Colonoscopy Prevents Deaths From Colon Cancer

The multi-institutional study included experts from various disciplines, including endoscopists, radiologists, pathologists, and epidemiologists. Researchers from the following institutions contributed to the study: Boston University School of Medicine (MA), Erasmus Medical Center (Netherlands), Minneapolis Veterans Administration (MN), Valley Presbyterian Hospital (CA), Cedars Sinai Medical Center (CA), Medical College of Wisconsin (WI), and Mount Sinai Medical Center (NY).

The work was supported by the National Cancer Institute, The Society of Memorial Sloan-Kettering Cancer Center Fund, the Tavel-Reznik Fund, and the Cantor Colon Cancer Fund.

Other studies have found that doctors vary in their ability to find polyps, that certain types of polyps are hard to detect and that colonoscopy is better at finding polyps in the lower part of the intestine than in its upper reaches.

Other screening tests look for blood in the stool, and if it is found, the patient is advised to have a colonoscopy. Another test, sigmoidoscopy, examines only the lower part of the colon. Barium enemas with X-rays can also show some abnormal growths. But sigmoidoscopy and barium enemas are not used much anymore in the United States.

Stool tests need to be done once a year; many people do not comply. In fact, a study from Spain in the same issue of the journal as Dr. Winawer’s article found that when people were offered a stool test, only 34.2 percent took it. The figure for colonoscopy was even worse: 24.6 percent.

Cancer of the colon is one of the most common causes of death from cancer, ranking just behind lung cancer, among the types of cancer that affect men and women. Cancer can begin anywhere in the colon. The right colon begins in the right lower part of the abdomen. It ascends to the right upper part, across to the left upper part (in which it meets the left colon), and descends to the anus (the left colon). Most cancers of the colon begin as polyps - small, slow-growing, mushroom-like growths on the inner surface of the colon. Mutations in the genes that control cell division lead to more rapid growth and eventually invasion into the wall of the colon and beyond. The purpose of colon cancer screening is to detect and remove growths before they invade and spread. Experts recommend several effective screening methods. One is to inspect the entire colon through a flexible tube (colonoscopy), which is the most accurate. Because colonoscopy is the most expensive, inconvenient, and riskiest test, it is important to know whether colonoscopy reduces the chance of dying of colon cancer.


Source: Memorial Sloan-Kettering Cancer Center

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