Are Colonoscopies A Good Cancer Screening Tool?

A doctor inserting a long, flexible tube outfitted with a small camera up your rectum to examine your bowels is not a surgery that most people look forward to.

For years, having a colonoscopy, the second-deadliest malignancy in the world, performed on middle-aged adults has been an uncomfortable and dreaded rite of passage.

According to a groundbreaking study, colonoscopies may not be as helpful as they once were as a screening tool for cancer since many people still find the process to be intimidating.

Inviting people to a colonoscopy only reduced the risk of bowel cancer by roughly one-fifth, according to a major northern European experiment that tracked over 85,000 participants after ten years. It also did not significantly lower the chance of cancer-related death.

In an editorial accompanying the study, published in The New England Journal of Medicine, gastrointestinal experts described the findings as “both surprising and disheartening.”

Cancer advocacy organizations, however, were quick to point out the study’s flaws and stress the value of colonoscopy in finding cancer early, when it is most easily treated.

The reported benefits of the operation were probably diminished since only a small portion of the study participants who were invited to undergo a colonoscopy actually showed up to get one.

The researchers intend to repeat their analysis after 15 years because recent advancements in cancer treatments may make it too early to demonstrate a real benefit from colonoscopy screening at 10 years.

“Preventive cancer screenings are the best and most trusted way to save lives,” Dr Karen Knudsen, Chief Executive Officer at the American Cancer Society, said in a statement reacting to the study.

“That’s why the American Cancer Society recommends colorectal cancer screening, colonoscopy, for adults beginning at age 45. There’s no reason to change that direction. Recommended cancer screenings should be a routine part of good health”.

Low uptake of colonoscopies

The primary colorectal cancer screening test now used in the United States is a colonoscopy, which medical professionals advise having done every ten years.

Inversely, colonoscopy screening has not been widely used in other regions of the world, in part due to a lack of evidence from randomized trials regarding its efficacy.

The majority of European nations have chosen to concentrate on employing less expensive fecal immunochemical tests (FIT), which check for blood in your stool.

This is the first study to compare colonoscopy screening to no screening in a randomized controlled trial, which is considered the gold standard in clinical research.

The team, lead by University of Oslo researchers, began its research more than a decade ago, enrolling more than 84,000 participants aged 55 to 64 from Poland, Norway, and Sweden.

A colonoscopy invitation was sent to around 28,000 of the participants at random, while the remaining participants received their regular care, which did not involve routine colonoscopy screening.

The people who were invited to a colonoscopy had an 18% lower risk of colon cancer than those who were never invited to a screening, however there was no significant difference after 10 years.

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