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.
Abbreviations:
CRC (colorectal cancer)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 13, 2012
Accepted:
February 20,
2012
Received:
October 31,
2011
Footnotes
DISCLOSURE: The initial screening study was supported by grants to Prof. Urs Marbet from the Swiss and Regional Cancer Leagues of Central Switzerland Glarus, the Gastroenterological Society GastroMed Swiss, and the Basel Foundation for Cancer Research. No other financial relationships relevant to this publication were disclosed.
If you would like to chat with an author of this article, you may contact Dr Marbet at [email protected]
Identification
Copyright
© 2012 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
