TUESDAY, Oct. 11, 2022 — Participants who are invited to undergo screening colonoscopy have a reduced risk for colorectal cancer at 10 years but no reduction in the risk for death from colorectal cancer, according to a study published online Oct. 9 in the New England Journal of Medicine to coincide with United European Gastroenterology Week, held from Oct. 8 to 11 in Vienna.
Michael Bretthauer, M.D., Ph.D., from the University of Oslo in Norway, and colleagues conducted a pragmatic, randomized trial involving 84,585 healthy men and women aged 55 to 64 years drawn from population registries in Poland, Norway, Sweden, and the Netherlands between 2009 and 2014. Participants were randomly assigned to receive an invitation to undergo single-screening colonoscopy (28,220 individuals, of whom 11,843 [42.0 percent] underwent screening) or to receive no invitation or screening (usual-care group; 56,365 participants).
The researchers found that 259 cases of colorectal cancer were diagnosed in the invited group compared with 622 cases in the usual-care group during a median follow-up of 10 years. The risk for colorectal cancer at 10 years was 0.98 and 1.20 percent in the invited and usual-care groups, respectively, in intention-to-screen analyses, with a risk reduction of 18 percent (risk ratio, 0.82; 95 percent confidence interval, 0.70 to 0.93). The risk for death from colorectal cancer was 0.28 and 0.31 percent in the invited and usual-care groups, respectively (risk ratio, 0.90; 95 percent confidence interval, 0.64 to 1.16).
“This relatively small reduction in the risk of colorectal cancer and the nonsignificant reduction in the risk of death are both surprising and disappointing,” write the authors of an accompanying editorial.
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Posted October 2022