Thursday, June 18, 2015

Quality of colonoscopy exam matters

CANCER DIGEST – June 18, 2015 – Patients whose doctors tend to detect more adenomas, or abnormalities in the intestines had a 50 to 60 percent lower lifetime risk of dying of colorectal cancer, a new analysis shows.

The researchers led by Reinier G.S. Meester, M.Sc., of Erasmus Medical Center University Rotterdam, the Netherlands analyzed data from 57,000 patients in the Kaiser Permanente health system who underwent colonoscopies administered by 136 different gastrointestinal specialists. The study was published in the June 16 Journal of the American Medical Association.

Adenomas are abnormal growths in glandular cells in the intestines, which are associated with a higher risk of becoming cancerous. Finding them among the twists and turns and folds within the intestine during a colonoscopy is a matter of skill, experience and thoroughness of the doctor performing the procedure.

The researchers used the data collected from the patients in a statistical model to estimate the number of colorectal cancers that would occur over the patients’ lifetimes. They estimated that about 34 people in 1,000 who never have a colonoscopy would be diagnosed with cancer and a little more than 13 of them would die of colorectal cancer.

For people whose doctors had the lowest rate of detecting adenomas the risk was 26.6 in 1,000 would receive a diagnosis of cancer over their lifetimes compared to 12 in 1,000 among those whose doctors had the highest rate of detecting adenomas. 

Dividing the doctors by detection rates into five groups, the researchers estimated that the chance of dying from colorectal cancer decreased by 11 to 13 percent for patients screened by doctors in each successively higher group of detection rates. In other words, those whose doctors had the lowest detection rate had a 50 to 60 percent higher chance of dying of colorectal cancer than those patients whose doctors had the highest rates of detection. 

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