Nonuse of colonoscopy doubles colorectal cancer mortality

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Colonoscopy is estimated to have reduced the rates of colorectal cancer mortality, but many more deaths could have been prevented with more widespread use of the technique, contend researchers.

In a special issue of the journal GIE: Gastrointestinal Endoscopy (2011;73[3]:435-443.e5) devoted to issues related to March's National Colorectal Cancer Awareness Month, Christian Stock, MSc, and colleagues described their efforts to determine the effect of current colonoscopy use on colorectal cancer (CRC) mortality and its further potential in reducing such mortality. They obtained data on the 2005 US population, aged 50 years and older (reflecting the screening-eligible age), from the National Health Interview Survey; the Surveillance, Epidemiology, and End Results (SEER) Program, and estimates of the effectiveness of colonoscopy at reducing CRC mortality.

The investigators' statistical analysis indicated that overall, the numbers (and proportions) of CRC deaths prevented by colonoscopy in 2005 ranged from 7,314 (13%) to 11,711 (19%) across the estimates of colonoscopy effectiveness.

However, approximately twice as many deaths occurred due to the nonuse of colonoscopy: Calculations showed that the numbers (and proportions) of CRC deaths attributable to nonuse of colonoscopy ranged from 13,796 (28%) to 22,088 (44%), depending on the assumed effectiveness.

“These findings highlight the potential benefits from public health interventions to increase the use of screening colonoscopy,” concluded the authors.

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