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Colorectal cancer screening linked to reduced late-stage disease
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Screening colonoscopy or sigmoidoscopy was associated with reduced incidence of certain late-stage colorectal cancers, according to results of a nested case-control study.
Chyke A. Doubeni, MD, FRCS, MPH, presidential associate professor of family medicine and community health at the University of Pennsylvania’s Perelman School of Medicine, and colleagues designed the study to investigate links between screening colonoscopy and late-stage colorectal cancer risk.
Chyke A. Doubeni
The study included 1,039 average-risk adults. Eligible participants were aged 55 to 85 years at diagnosis, had stage IIb or higher disease, and had been enrolled for at least 5 years in one of the participating health plans between 2006 and 2008. Medical records revealed if patients had received colonoscopy or sigmoidoscopy 3 months to 10 years before the reference date.
The final analysis included 471 case patients and 509 control patients.
Screening colonoscopy was performed in 2.8% of the case patients and 9% of control patient. This corresponded to an adjusted OR of 0.29 (95% CI, 0.15-0.58) for any late-stage disease, 0.36 (95% CI, 0.16-0.80) for right colon cancer and 0.26 (95% CI, 0.06-1.11) for left colon/rectum cancer, according to study results.
Results remained unchanged when researchers only considered high-quality tests or those performed by gastroenterologists, the researchers said.
“Future randomized trials and well-designed observational studies of the effect of screening colonoscopy on colorectal cancer mortality in average-risk persons are needed to understand whether this reduced risk for late-stage colorectal cancer in the right colon that we observed in this study translates to decreased risk for colorectal cancer death,” Doubeni and colleagues wrote.
The rates of sigmoidoscopy were 19.5% in the study group and 34% among control patients. This was associated with an adjusted OR of 0.50 (95% CI, 0.36-0.70) overall, 0.79 (95% CI, 0.51-1.23) for right colon late-stage disease and 0.26 (95% CI, 0.14-0.48) for left colon cancer.
The researchers cited the small sample size and the fact screening colonoscopy was relatively uncommon during the study observation period as potential limitations of the study.
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