Colonoscopic Polypectomy Reduces Long-Term Colorectal Cancer Mortality

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(ChemotherapyAdvisor) – Colonoscopic removal of adenomatous polyps prevents death from colorectal cancer, a study in the February 23 issue of The New England Journal of Medicine has found.

Data on patients prospectively referred for initial colonoscopy at National Polyp Study clinical centers between 1980 and 1990 who had polyps (adenomas and nonadenomas) were analyzed using the National Death Index to identify deaths and determine cause of death.

Median follow-up was 15.8 years. Among 2,602 patients who had adenomas removed, 1,246 had died from any cause and 12 from colorectal cancer, the investigators noted. In the general population, 25.4 estimated deaths from colorectal cancer were expected. A standardized incidence-based mortality ratio of 0.47 with colonoscopic polypectomy suggested a 53% reduction in mortality.

During the first ten years after polypectomy, colorectal cancer mortality was similar among patients with adenomas and those with nonadenomatous polyps (RR=1.2).

“These combined findings indicate that adenomas identified and removed at colonoscopy include those that are clinically important, with the potential to progress to cancer and cause death. A demonstrated reduction in mortality with colonoscopic polypectomy is a critical prerequisite for continued recommendations of screening colonoscopy in clinical practice while we wait for the results of randomized, controlled trials of screening colonoscopy,” the study authors concluded.

Abstract

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