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Colonoscopy Can Be Stretched Out For Some People, Study Suggests

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Colonoscopy Can Be Stretched Out For Some People, Study Suggests

(CTN News) – In a recently published study, researchers asked whether some people can delay repeating a colonoscopy after a negative initial screening for colorectal cancer.

The study, published in JAMA Internal Medicine, looked at 120,000 people 65 and older in Germany from 2013 to 2019 who had a colonoscopy 10 or more years after an initial negative screening, and compared them with all colonoscopy screenings conducted on people 65 and older in that period – most of whom were getting their first colonoscopy.

Ten or more years after a negative colonoscopy, only 4% to 5% of women and 5% to 7% of men had advanced growths or cancer.

In addition, the researchers assessed whether men and women had different rates of abnormal growth, finding that men had a 40% higher prevalence.

A person 75 years or older had the highest detection rate when looking at detection rates by age.

In some cases, especially for females and young people without gastrointestinal symptoms, long-term screening intervals for colonoscopies may be warranted, the authors conclude.

According to the study authors, women at younger ages who did not have an index colonoscopy could potentially be screened at longer intervals or, alternatively, may be offered less invasive methods, such as stool tests, while maintaining the 10-year interval for men and women over the age of 60.

Recommendations for a colonoscopy

In the United States, colorectal cancer is the second leading cause of cancer death. With effective screening tests like colonoscopies that can detect early signs of cancer, it is also one of the most preventable cancers.

In recent decades, colonoscopies have largely been responsible for reducing death rates from colorectal cancer.

Currently, all adults between the ages of 45 and 75 are recommended to be screened for colorectal cancer.

As more cancers are being diagnosed at younger ages, screening recommendations have recently been changed to start at 45 instead of 50. After a negative screening, patients do not need another one for 10 years.

According to Douglas Owens, a health policy professor at Stanford University and former chair of the US Preventive Services Task Force, the findings show promise.

“(Colorectal cancer) is not like other cancers where over screening can cause serious harm. It’s small, but it’s not zero, and it comes from a colonoscopy.

The same benefit could be achieved with fewer colonoscopies, Owens said.

Dr. Robert Bresalier, professor of gastrointestinal oncology at MD Anderson Cancer Center, would like to see more research on extending screening intervals.

Screening colonoscopy at 10-year intervals for asymptomatic individuals is cost-effective and effective. I don’t think I’m ready to change.

Bresalier said the study is comforting, but it is not ready to change practice with regards to extending the interval based on the results. It is clear from this study that we can feel comfortable with the current guidelines.”

Researchers note that their findings don’t apply to individuals who might need a colonoscopy at earlier intervals to assess symptoms such as rectal bleeding.

In addition, these individuals are at a higher risk of colorectal cancer. According to them, generalizing their findings should be done with caution.

All eligible groups should undergo colonoscopies, according to experts.

“(This study) confirms the importance of screening for colon cancer, and that there are many ways to do it effectively,” Owens said.

Despite colonoscopy being the gold standard for colon cancer screening, there are alternatives. Fecal occult blood tests, which check for blood in the stool, are another screening option.

“The most critical thing is to get screened. Choose either a stool test or a colonoscopy. It doesn’t matter. Whatever suits your preferences, do it,” Owens advised.

Despite public health advocates’ pleas, more than a quarter of eligible Americans don’t get screened for colorectal cancer.

Currently, screening is the biggest impact we can have – and is relevant to this discussion. If you are in that age group and haven’t been screened, you should.

In terms of influencing colorectal cancer death, that is the biggest impact we can have at this point,” Bresalier explained.

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