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No increase in mortality rate before, after colonoscopy screening
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Despite an increase in unplanned hospitalizations, colonoscopy is not associated with any increase in mortality as a colorectal cancer screening intervention, according to study results.
“Analyses of mortality and unplanned hospital admissions are essential in assessment of risk to benefit ratio of the policy,” Piotr Spychalski, MD, of the department of general, endocrine and transplant surgery at the Medical University of Gdansk in Poland, and colleagues wrote. “Comparative design of this randomized health services study offers the possibility to extract the rates related to screening colonoscopy as a health care policy from overall rates in matched control group.”
Researchers assigned individuals aged 55 to 64 years covered by the Polish Colonoscopy Screening Program to groups that were either immediately invited for screening colonoscopy (n= 338,477) or a matched group that would be invited in 5 years. A total of 55,390 individuals from the colonoscopy group underwent screening. Individuals in the control group were assigned “virtual” dates of colonoscopy.
Investigators compared mortality and hospitalization 6 weeks before and 30 days after the actual or virtual dates of colonoscopy in the screening and control groups.
In an intention-to-treat analysis, Spychalski and colleagues found that there was no significant difference in mortality rates between the two groups (0.22% vs. 0.22%). However, during the entire observation period, the overall rate of unplanned hospitalizations was higher for the colonoscopy group compared with the control group (2.39% vs. 2.31; risk difference 0.08%; 95 %CI, 0.01%–0.15%).
The risk difference was due to a higher rate of hospitalizations after screening (1.1% vs. 1.01%; risk difference 0.09%; 95% CI, 0.04%–0.14%).
Spychalski and colleagues wrote that their findings show that colonoscopies do not increase mortality as a CRC screening intervention despite more hospitalizations.
“Colonoscopy screening programs should not be considered as a substantial burden both for populations and health care providers,” they wrote. “Nevertheless, the financial consequence of additional hospitalizations should be taken into account when performing cost-effectiveness analyses.” – by Alex Young
Disclosures: Spychalski reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.
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