Understanding the Recent European Screening Colonoscopy Trial
Last month, medical news was flooded with headlines claiming that screening colonoscopies may not be as beneficial as originally thought. These claims were based on a randomized trial conducted in Europe, which was recently published in the New England Journal of Medicine. These flashy headlines unfortunately did not accurately capture the study findings, which do support the benefit of screening colonoscopies in reducing colorectal cancer occurrence and death.
This study included healthy men and women 55 to 64 years of age who were randomized to either the intervention or control group. The intervention group was invited to receive a screening colonoscopy whereas the control group did not receive this invitation. The authors found that after 10 years, the risk of colorectal cancer was 0.98% in those who were invited versus 1.2% in the control group and the risk of colorectal cancer death was 0.28% versus 0.31%, respectively. This small improvement does not, however capture the true benefit of colonoscopy because only 42% of those who were invited received the colonoscopy. If you compare those who received the colonoscopy versus those who did not, colonoscopy reduced the risk of colon cancer by 31% and the risk of dying from colorectal cancer by 50%. This highlights the value of continued screening.
Colon cancer is one of the most common cancers. To prevent colon cancer and death the BC Cancer Agency continues to recommend screening for asymptomatic people between 50 to 74 years of age. For average risk individuals, this can be done with a non-invasive fecal immunochemical test (FIT) every 2 years. For those at higher risk, a colonoscopy is the preferred screening method and should be completed every 10 years.
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Dr. Sarah Soles, ND
Bretthauer, M., Løberg, M., Wieszczy, P., Kalager, M., Emilsson, L., Garborg, K., Rupinski, M., Dekker, E., Spaander, M., Bugajski, M., Holme, Ø., Zauber, A. G., Pilonis, N. D., Mroz, A., Kuipers, E. J., Shi, J., Hernán, M. A., Adami, H. O., Regula, J., Hoff, G., … NordICC Study Group (2022). Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death. The New England journal of medicine, 387(17), 1547–1556.