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Meta-Analysis on Lower-GI Endoscopy Offers Reassurance, But Not Resolution — Physician’s First Watch

Medical News |
April 14, 2014

Meta-Analysis on Lower-GI Endoscopy Offers Reassurance, But Not Resolution

By Joe Elia

Evidence that screening with either sigmoidoscopy or colonoscopy greatly reduces overall risks for colorectal cancer is "compelling and consistent," according to a BMJ meta-analysis. However, choosing between the approaches will have to await the results of long-range studies.

Sigmoidoscopy, in randomized trials versus no endoscopy, brought an 18% reduction in incidence and a 28% reduction in deaths from the disease. Those effects were even stronger when only distal cancers were considered. Rates for proximal cancers didn't show significant declines, however.

Colonoscopy, in observational studies versus no endoscopy, also provided good overall protection, but was significantly more protective than sigmoidoscopy only in death rates from proximal cancers.

The authors write that a large randomized trial of colonoscopy versus no endoscopy won't be completed until the 2020s. Meanwhile they advise that colonoscopy's apparent advantage should be weighed against its higher cost, complexity, and complication rates.

Reader Comments (1)

karl hattensr Physician, Internal Medicine

Human effectiveness has been proven . the financial effectiveness will be discussed repeatedly by government.

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