Risk of colorectal cancer extremely low 5 years after a normal colonoscopy screening

September 23, 2008

A study appearing in the Sept. 18 issue of the New England Journal of Medicine shows that among individuals with no colorectal neoplasia (abnormal growths) on initial screening colonoscopy, the five-year risk of colorectal cancer is extremely low. The data provides support for rescreening at an interval of five years or longer after a normal colonoscopic examination.

"This research is very significant as it is the first large study to provide direct rescreening data on a group of average risk patients who had normal findings on the initial screening colonoscopy," said John L. Petrini, MD, FASGE, president, American Society for Gastrointestinal Endoscopy (ASGE). "As a result, physicians should consider this important finding when recommending a rescreening schedule to their patients, as this data could have an impact on the costs of colonoscopy and the resources to provide for colonoscopy. There is data suggesting that the procedure may be performed too frequently."

Researchers, led by Thomas F. Imperiale, MD, of the Indiana University School of Medicine and the Regenstrief Institute, examined 1,256 asymptomatic patients 50 years or older, who had no precancerous or cancerous findings on baseline colonoscopy and who underwent follow up colonoscopy at five years. Among this patient population, no cancers were discovered. Advanced adenomas were found in 16 patients (1.3 percent).

ASGE and American Cancer Society colorectal cancer screening guidelines for patients with normal findings on the initial screening colonoscopy recommend repeat screening for average risk individuals every 10 years if they have no symptoms or family history risk. While this data does not directly evaluate the 10-year recommendation, it does establish that colonoscopy screening does not need to be repeated before five years for average risk individuals.

An estimated 49,960 deaths are expected to occur from colorectal cancer in 2008. According to a study released in October 2007 from the CDC and the American Cancer Society, colorectal cancer deaths dropped nearly 5 percent between 2002 and 2004, more than the other major cancer killers (prostate, breast, and lung). Among the key factors playing a role in the decline was prevention through screening and the removal of precancerous polyps.

"This is excellent news and reinforces the importance of colorectal cancer screening beginning at age 50, or even younger if there is a family history of colorectal cancer or polyps," said Petrini. "Colonoscopy plays a very important role in colorectal cancer screening and prevention because it is the only method that allows us to remove polyps before they turn into cancer."

American Society for Gastrointestinal Endoscopy

---

---

	American Cancer Society's Complete Guide to Colorectal Cancer by American Cancer Society (Author), Bernard Levin (Editor), Terri Ades (Editor), Katie Couric (Editor) Created by a prestigious panel of experts, this new book offers comprehensive coverage of colorectal cancer, the second most prevalent form of cancer in the world, which, with proper screening, is almost entirely preventable. It provides up-to-date, essential information about the disease, including prevention, detection, diagnosis, treatment options, complementary and alternative therapies, coping, living well with cancer, caregiving, and much more. Throughout the text real cancer survivors offer their experience dealing with this disease, from diagnosis to treatment and beyond.
	ABC of Colorectal Cancer (ABC Series) by Annie Young (Editor), Richard Hobbs (Editor), David Kerr (Editor) Colorectal cancer is a common cause of morbidity and mortality in which prevention, screening and early detection are vital. Beginning with the patient perspective and following the patient pathway, this new second edition covers epidemiology and prevention, screening programmes, decision support networks, the role of primary care, and supportive care for patients with colorectal cancer.The ABC of Colorectal Cancer provides the core knowledge on clinical genetics, diagnosis, imaging, therapy and surgery options and the latest evidence based guidelines for treating and managing colorectal cancer patients within the multidisciplinary team. Highly illustrated and accessible, it covers the full spectrum of the disease to provide the basis to make a real difference to clinical management.This...
	Be a Survivor Colorectal Cancer Treatment Guide by Vladimir Lange (Author) Dr. Lange’s comprehensive overview of cancer and treatment options offers detailed information using simple, concise language and a wide variety of color photos and drawings. Colorectal cancer patients need to know more about their disease, yet there is an overload of information. Be a Survivor gives the patient the specific, reliable and necessary information to make good decisions about their cancer and treatment options. Annually, 150,000 Americans are told they have colorectal cancer, making it one of the top three most common cancers in the United States. Diagnosed early, colorectal cancer is treatable, often curable, and vey preventable. This resource covers all aspects of colorectal cancer—from diagnosis to recovery, including a chapter for the patient's spouse.
	What Your Doctor May Not Tell You About(TM) Colorectal Cancer: New Tests, New Treatments, New Hope by Mark Bennett Pochapin (Author) - What Your Doctor May Not Tell You About Colorectal Cancer was published in Warner hardcover (0-446-53188-X) in 3/04. The book features a foreword by Katie Couric. - Dr. Pochapin made an appearance on the Today show in conjunction with the hardcover publication of this book. Previously, he had been chosen by Katie Couric to be the Medical Director of the Jay Monahan Center for Gastrointestinal Health, named in honor of Ms. Couric's late husband. - The author is an associate professor of clinical medicine at the Weill Medical College of Cornell University and Chief of Gastrointestinal Endoscopy at New York Presbyterian Hospital's Weill Cornell Medical Center. - There are approximately 100,000 new colorectal cancer cases diagnosed annually, making it the second leading cause of...
	Positive Options for Colorectal Cancer: Self-Help and Treatment by Carol Ann Larson (Author), Kathleen Ogle (Foreword) Colorectal cancer develops slowly over a period of several years, undetected, usually as polyps. It is a preventable and treatable disease if caught in time, yet most know little about how to read its symptoms. Written for the layperson, this book covers all the uncomfortable questions and answers about the disease, from prevention and warning signs, to screening and diagnosis techniques, to making decisions and developing treatment plans. Also included are positive stories about life after cancer by 12 survivors.
	COPING WITH COLORECTAL CANCER by Crystal Night Books DESCRIPTION: Coping With Colorectal Cancer – the prevention and cure of the second leading cause of cancer deaths is dedicated to helping reduce the toll this disease takes on human lives. It aims at prevention by teaching people to avoid the risk factors that lead to the disease, to save lives through leading victims to early detection, and presenting treatment options to those patients diagnosed with the disease. Colorectal cancer, also commonly called bowel cancer, is caused by uncontrolled cell growth in the colon, rectum, or appendix. Actually the majority colorectal cancers occurs due to lifestyle and increasing age, while a minority of cases are associated with underlying genetic disorders. Colorectal cancer typically starts in the lining of the bowel and...
	Colorectal Cancer: Evidence-based Chemotherapy Strategies (Current Clinical Oncology) by Leonard B. Saltz (Editor) Recent advances in the understanding of the biology of colorectal cancer have radically transformed the treatment options available to clinicians, leaving textbooks written only two years ago completely out of date. This evidence-based and data-driven guide presents reviews of cutting-edge therapies for colorectal cancer, all articulated by leading experts in the field. This integrated and focused consideration of colorectal management includes reviews of cytotoxic chemotherapy, targeted biologic therapies, as well as updates on adjuvant chemotherapy for colon cancer and combined modality management of rectal cancers. Attention is also focussed on the role of potentially curative multi-modality management of liver metastases, with considerations of the role of liver resection and...
	Colorectal Cancer Screening (Clinical Gastroenterology) by Joseph Anderson MD (Editor), Charles Kahi MD (Editor) Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening...
	100 Questions & Answers About Colorectal Cancer by David Bub (Author), Susannah L. Rose (Author), W. Douglas Wong (Author) Whether You’Re A Newly Diagnosed Cancer Patient, A Survivor, Or A Friend Or Relative Of Either, This Book Offers Help. The Only Text To Provide The Doctor’S And Patient’S View, The Second Edition Is Updated With Authoritative, Practical Answers To Your Questions About Treatment Options, Post-Treatment Quality Of Life, Sources Of Support, And Much More. This Book Is An Invaluable Resource For Anyone Coping With The Physical And Emotional Turmoil Of This Frightening Disease. The Authors Consist Of Two Oncologic Surgeons And A Cancer Care Social Worker From Memorial Sloan-Kettering Cancer Center. Commentary From Actual Colon And Rectal Cancer Survivors Provides A Unique, “Insider’S” Perspective.
	Understanding Colorectal Cancer Anatomical Chart by Anatomical Chart Company (Author) Understanding Colorectal Cancer Anatomical Chart defines colorectal cancer and shows colorectal anatomy with the following pathologies: Adenocarcinoma of colon Circumferential carcinoma of the transverse colon Colonic polyps Adenocarcinoma of jejunum Adenocarcinoma of the rectosigmoid region The chart describes risk factors, signs and symptoms, screening and diagnostic tests, and treatment options, and illustrates and explains the stages of cancer.