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Colonoscopy Remains Gold Standard for Preventing Colorectal Cancer

Colonoscopy Gold Standard

Colonoscopies are the single most effective way to prevent colorectal cancer, as well as death from colorectal cancer. While a recent study in the New England Journal of Medicine may lead people to think otherwise, the message from gastroenterologists is clear – colonoscopies in people age 45 and up is the gold standard.

The study that was released on October 9 implied that colonoscopies aren’t as beneficial as previously thought. But there are several major concerns with the study, especially in regard to medical care in the United States. And some news outlets may be missing some key points.

Here’s what you really need to know about colonoscopies.

Colonoscopy is Still the Gold Standard

It has long been known that having a colonoscopy, with a well-trained gastroenterologist, is the best chance to prevent colorectal cancer from forming or finding it early enough to treat it. Extensive evaluation of the subject led the US Preventive Services Task Force to lower the screening age to 45 – which will save thousands of lives.

Screening Colonoscopies Only Work When You Get One

It may seem like an obvious point, but avoiding a colonoscopy will not prevent colon cancer.

For the study, people were invited to get a colonoscopy, but only 42% of them actually did. The people who actually got a colonoscopy reduced their risk of dying from colorectal cancer was cut in half. It also reduced their chance of getting colorectal cancer in the first place by 31%.

This highlights that when you have a colonoscopy, you have a MUCH better chance of avoiding colorectal cancer than if you don’t get one at all.

The Study Does Not Represent the U.S.

While the study itself isn’t available to the general public, there were some challenges in the way it was set up, especially in how it relates to the United States.

This particular study involved the Nordic countries of Norway, Poland, and Sweden. This may mean that diverse populations similar to those in the U.S. were underrepresented. For example, Black men and Native Americans tend to have a higher risk of colorectal cancer, and this study doesn’t necessarily address that.

The study did highlight the fact that the skill of the gastroenterologist matters. Nearly one-third of the doctors in the study did not meet the minimum standard of adenoma detection rate (which is 25%). A recent study of U.S. doctors showed that the average detection rate was 39% – much higher than some of the doctors in the study.

Doctor training levels and access to advanced technology and equipment are highly variable across the globe.

The Bottom Line

Dr. Bret Petersen, President of the American Society for Gastrointestinal Endoscopy (ASGE), had this to say:

“This new study has too many unexplained issues to change the consensus regarding the benefit of colonoscopy. Colonoscopy, using modern endoscopy techniques and trained endoscopists, continues to be the single most important, proven, and effective way to detect and prevent colorectal cancer.”

The recommendation remains – start colonoscopies at age 45 – it may just save your life.

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