Colorectal Cancer Rescreening After Normal Initial Colonoscopy Would Save Lives, Study Finds

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(ChemotherapyAdvisor) – Colorectal cancer (CRC) rescreening after a normal initial colonoscopy exam saves lives regardless of the screening modality used, but the cost and risk of complications associated with endoscopic colonoscopy make other rescreening tools more attractive alternatives, according to a new study published in the Annals of Internal Medicine.

Rescreening with any method “substantially reduced” the risk for colorectal cancer deaths compared with no subsequent screening, reported lead author Amy B. Knudsen, PhD, of the Massachusetts General Hospital in Boston, and coauthors.

“Rescreening with HSFOBT, FIT or CTC had fewer complications and was less costly than continuing colonoscopy,” they noted.

The authors used the validated SimCRC microsimulation model and data from the US National Cancer Institute (NCI)'s Surveillance, Epidemiology, and End Results Program (SEER) to assess outcomes following a normal initial colonoscopy exam. They compared model outcomes associated with no further screening versus rescreening starting at age 60 years using colonoscopy (every 10 years), or using annual highly-sensitive guaiac fecal occult blood testing (HSFOBT), annual fecal immunochemical testing (FIT), or computed tomographic colonography (CTC) every 5 years.

The simulation predicted up to 75% to 80% reductions in CRC deaths associated with rescreening after a normal initial colonoscopy, compared to no subsequent screening after a normal initial exam.

“Compared with the currently recommended strategy of continuing colonoscopy every 10 years after initial negative examination, rescreening at age 60 years with annual HSFOBT, annual FIT, or CTC every 5 years provides approximately the same benefit in life-years with fewer complications at lower cost,” the authors wrote. “Therefore, it is reasonable to use other methods to rescreen persons with negative colonoscopy results.”

The study was funded by the NCI.


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