Colonoscopy screening every ten years could prevent 40% of colorectal cancers

Study supports 10-year screening interval, with more frequent intervals if personal history of adenoma or family history of colorectal cancer

2013-09-19

(Press-News.org) Boston, MA -- According to a large, long-term study from Harvard School of Public Health (HSPH), 40% of all colorectal cancers might be prevented if people underwent regular colonoscopy screening. The new research also supports existing guidelines that recommend that people with an average risk of colorectal cancer should have a colonoscopy every 10 years.

The new study helps address previous uncertainty about the effectiveness of colonoscopy in reducing colorectal cancer incidence and mortality -- particularly among people with cancer that originates in the proximal, or upper part of the colon.

The study appears in the September 19, 2013 edition of the New England Journal of Medicine.

"Colonoscopy is the most commonly used screening test in the U.S. but there was insufficient evidence on how much it reduces the risk of proximal colon cancer and how often people should undergo the procedure," said Shuji Ogino, co-senior author and associate professor in the Department of Epidemiology at HSPH. "Our study provides strong evidence that colonoscopy is an effective technique for preventing cancers of both distal and proximal regions of the colorectum, while sigmoidoscopy alone is insufficient for preventing proximal cancer."

According to the most recent statistics from the Centers for Disease Control and Prevention, nearly 137,000 people in the U.S. were diagnosed with colorectal cancer in 2009, and nearly 52,000 died that year from the disease. Colorectal cancer is the second-leading cause of cancer-related death in the nation.

The researchers analyzed data from 88,902 participants in two long-term studies: the Nurses' Health Study and the Health Professionals Follow-up Study. Based on data from questionnaires that participants filled out every two years between 1988 and 2008, the researchers obtained information on colonoscopy and sigmoidoscopy procedures. They documented 1,815 cases of colorectal cancer and 474 deaths from the disease.

They found that both colonoscopy and sigmoidoscopy -- which screens for tumors in the distal, or lower part of the colorectum -- were associated with decreased risk of either getting colorectal cancer or dying from it. Only colonoscopy decreased the risk for cancers originating in the proximal colon, but not to the degree of its protective effect against distal colorectal cancers. The researchers suggested that colonoscopy's smaller effect in reducing risk for tumors in the proximal colon might be due in part to molecular or biological differences in those cancers.

Other findings include:

The researchers estimated that if all participants in the study had undergone colonoscopies, 40% of colorectal cancers -- including 61% of distal cancers and 22% of proximal cancers -- would have been prevented.

Sigmoidoscopy alone is likely insufficient for reducing the incidence or death risk of colorectal cancer that originates in the upper colon.

People who get a clean bill of health after a colonoscopy have a significantly reduced risk of colorectal cancer for up to 15 years after the procedure, although the data support repeat screening at shorter intervals among individuals with a personal history of adenoma -- a benign tumor of glandular origin that can become malignant over time -- or a family history of colorectal cancer.

Colorectal cancers diagnosed within five years of a colonoscopy had different molecular characteristics compared with cancers diagnosed more than five years after a colonoscopy, and they may be difficult to detect or completely remove.

"Each year, more than 1.2 million people are diagnosed with colorectal cancer worldwide. Our findings could help improve and strengthen the current guidelines for colorectal cancer screening," said Reiko Nishihara, lead author and research fellow in the Department of Nutrition at HSPH.

Support for the study came from the National Institutes of Health (P01 CA87969, P01 CA55075, 1UM1 CA167552, P50 CA127003, R01 CA151993, R01 CA137178, and K24 DK098311); the Bennett Family Foundation; and the Entertainment Industry Foundation through the National Colorectal Cancer Research Alliance.

"Long-term colorectal-cancer incidence and mortality after lower endoscopy," Reiko Nishihara, Kana Wu, Paul Lochhead, Teppei Morikawa, Xiaoyun Liao, Zhi Rong Qian, Kentaro Inamura, Sun A. Kim, Aya Kuchiba, Mai Yamauchi, Yu Imamura, Walter C. Willett, Bernard A. Rosner, Charles S. Fuchs, Edward Giovannucci, Shuji Ogino, Andrew T. Chan, New England Journal of Medicine, September 19, 2013, 369:1095-1105

Visit the HSPH website for the latest news, press releases and multimedia offerings.

###

Harvard School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people's lives -- not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at HSPH teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America's first professional training program in public health.

HSPH on Twitter: http://twitter.com/HarvardHSPH

HSPH on Facebook: http://www.facebook.com/harvardpublichealth

HSPH on You Tube: http://www.youtube.com/user/HarvardPublicHealth

HSPH home page: http://www.hsph.harvard.edu

ELSE PRESS RELEASES FROM THIS DATE:

More than 40 million episodes of poor care in hospitals every year worldwide

2013-09-19

Two thirds of these occur in low and middle income countries, the figures suggest. The authors base their findings on 4000 articles written in English and published from 1976 onwards, which looked at substandard medical care given to hospital patients around the globe. The researchers focused on seven key markers for substandard care: harm from prescribed medications; urinary tract infections associated with catheters; bloodstream infections associated with catheters; pneumonia acquired in hospital; blood clots (VTEs);falls; and bed sores. They used an approach similar ...

Why parents think your partner isn't good enough

2013-09-19

It is common for parents to influence mate choice — from arranged marriages to more subtle forms of persuasion — but they often disagree with their children about what makes a suitable partner. A new study has found an evolutionary explanation for why some parents try to control who their children pair up with. The study, involving a University of Bristol researcher and published today in the journal Evolution & Human Behavior, shows that this conflict over mate choice may be rooted in an evolutionary conflict over resources. Dr Tim Fawcett, a research fellow in Bristol's ...

UEA scientists reveal Earth's habitable lifetime and investigate potential for alien life

2013-09-19

Habitable conditions on Earth will be possible for at least another 1.75 billion years – according to astrobiologists at the University of East Anglia. Findings published today in the journal Astrobiology reveal the habitable lifetime of planet Earth – based on our distance from the sun and temperatures at which it is possible for the planet to have liquid water. The research team looked to the stars for inspiration. Using recently discovered planets outside our solar system (exoplanets) as examples, they investigated the potential for these planets to host life. The ...

Millions harmed each year from unsafe medical care

2013-09-19

Boston, MA – More than 43 million people are injured worldwide each year due to unsafe medical care, according to a new study from Harvard School of Public Health (HSPH). These injuries result in the loss of nearly 23 million years of "healthy" life. The findings represent a major new effort to calculate the global burden of unsafe medical care across a range of adverse health events. The study appears online September 18, 2013 in BMJ Quality & Safety. "This is the first attempt to quantify the human suffering that results from unsafe care," said lead author Ashish ...

Coma: Researchers observe never-before-detected brain activity

2013-09-19

Researchers from the University of Montreal and their colleagues have found brain activity beyond a flat line EEG, which they have called Nu-complexes (from the Greek letter Νν). According to existing scientific data, researchers and doctors had established that beyond the so-called "flat line" (flat electroencephalogram or EEG), there is nothing at all, no brain activity, no possibility of life. This major discovery suggests that there is a whole new frontier in animal and human brain functioning. The researchers observed a human patient in an extreme deep hypoxic ...

National registry report shows increase in radial stenting, other CV trends

2013-09-19

Cardiologists are increasingly accessing coronary arteries by way of the wrist rather than the groin to insert life-saving stents into patients with blocked arteries, according to the first broad report of the American College of Cardiology's clinical data registries published online today in the Journal of the American College of Cardiology. The report, "Cardiovascular Care Facts: A Report from the National Cardiovascular Data Registry - 2011," includes data about stents from the CathPCI Registry, the ACC's national database of hospital records on stenting and angioplasty, ...

Scientists discover the origins of genomic 'dark matter'

2013-09-19

A duo of scientists at Penn State University has achieved a major milestone in understanding how genomic "dark matter" originates. This "dark matter" -- called non-coding RNA -- does not contain the blueprint for making proteins and yet it comprises more than 95 percent of the human genome. The researchers have discovered that essentially all coding and non-coding RNA originates at the same types of locations along the human genome. The team's findings eventually may help to pinpoint exactly where complex-disease traits reside, since the genetic origins of many diseases ...

New sensor could prolong the lifespan of high-temperature engines

2013-09-19

A temperature sensor developed by researchers at the University of Cambridge could improve the efficiency, control and safety of high-temperature engines. The sensor minimises drift –degradation of the sensor which results in faulty temperature readings and reduces the longevity of engine components. The new sensor, or thermocouple, has been shown to reduce drift by 80 per cent at temperatures of 1200 degrees Celsius, and by 90 per cent at 1300 degrees Celsius, potentially doubling the lifespan of engine components. The results are published in the September issue of ...

Novel gene discovery could lead to new HIV treatments

2013-09-19

A team of researchers led by King's College London has for the first time identified a new gene which may have the ability to prevent HIV, the virus that causes AIDS, from spreading after it enters the body. Published in Nature today, the study is the first to identify a role for the human MX2 gene in inhibiting HIV. Researchers say this gene could be a new target for effective, less toxic treatments where the body's own natural defence system is mobilised against the virus. The work was funded by the Medical Research Council and the National Institute for Health ...

Study in New England Journal of Medicine: Colonoscopy saves lives

2013-09-19

Bethesda, MD (Sept. 18, 2013) — A study published in the Sept. 19 New England Journal of Medicine provides some of the clearest evidence to date that colonoscopy has advantages over sigmoidoscopy for the prevention of colorectal cancer. Researchers followed 88,902 study participants for 22 years and found that 1,815 developed colorectal cancer. Investigators estimated that 40 percent of those cancers could have been prevented if all of the patients in the study had received colonoscopy. "Thanks to colonoscopy, fewer people than ever before are developing or dying from ...

Colonoscopy screening every ten years could prevent 40% of colorectal cancers

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: