Gastrointestinal endoscopy · 2012
Colonoscopy screening markedly reduces the occurrence of colon carcinomas and carcinoma-related death: a closed cohort study.
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Manser Christine N, Bachmann Lucas M, Brunner Jakob, Hunold Fritz, Bauerfeind Peter, Marbet Urs A
Аннотация
BACKGROUND: Colonoscopy with a possible polypectomy is an efficient and preferred screening method to reduce the incidence of colorectal cancer (CRC). However, critics argue that, to date, a reduction of incidence and mortality from CRC has not been demonstrated in a population-based setting.
OBJECTIVE: To compare the incidence of and mortality from CRC among individuals screened by colonoscopy and non-screened individuals.
DESIGN: A closed cohort study.
SETTING: Population-based setting in a precisely defined area with a low level of population migration.
PATIENTS: This study involved 1912 screened and 20,774 control participants.
INTERVENTION: CRC cases in this closed cohort study were prospectively collected during the screening period of 1 year and the follow-up period of 6 years.
MAIN OUTCOME MEASUREMENTS: Follow-up data were corrected for negligible migration balance in the area. Tumor characteristics and risk or protective factors, age and sex, participation in general health screening examinations, history of CRC in a first-degree relative, smoking status, body mass index, frequency of sports activity, eating habits, and patients' professions were recorded.
RESULTS: Overall cancer incidence was significantly lower in the screened group compared with the non-screened group (adjusted odds ratio [OR] 0.31; 95% confidence interval [CI], 0.16-0.59; P < .001). Colon cancer-associated mortality also was clearly lower (adjusted OR 0.12; 95% CI, 0.01-0.93; P = .04). Risk factors such as lifestyle, smoking, and body mass index as well as family history were similar in both groups. Blue-collar workers had a higher incidence of CRC compared with professionals. The risk factors for CRC were a positive family history and smoking.
LIMITATIONS: Number and ethnicity of the participants, non-randomized study.
CONCLUSION: Colonoscopy with polypectomy significantly reduces CRC incidence and cancer-related mortality in the general population.
OBJECTIVE: To compare the incidence of and mortality from CRC among individuals screened by colonoscopy and non-screened individuals.
DESIGN: A closed cohort study.
SETTING: Population-based setting in a precisely defined area with a low level of population migration.
PATIENTS: This study involved 1912 screened and 20,774 control participants.
INTERVENTION: CRC cases in this closed cohort study were prospectively collected during the screening period of 1 year and the follow-up period of 6 years.
MAIN OUTCOME MEASUREMENTS: Follow-up data were corrected for negligible migration balance in the area. Tumor characteristics and risk or protective factors, age and sex, participation in general health screening examinations, history of CRC in a first-degree relative, smoking status, body mass index, frequency of sports activity, eating habits, and patients' professions were recorded.
RESULTS: Overall cancer incidence was significantly lower in the screened group compared with the non-screened group (adjusted odds ratio [OR] 0.31; 95% confidence interval [CI], 0.16-0.59; P < .001). Colon cancer-associated mortality also was clearly lower (adjusted OR 0.12; 95% CI, 0.01-0.93; P = .04). Risk factors such as lifestyle, smoking, and body mass index as well as family history were similar in both groups. Blue-collar workers had a higher incidence of CRC compared with professionals. The risk factors for CRC were a positive family history and smoking.
LIMITATIONS: Number and ethnicity of the participants, non-randomized study.
CONCLUSION: Colonoscopy with polypectomy significantly reduces CRC incidence and cancer-related mortality in the general population.