http://www.cancernetwork.com/nurses/content/article/10165/2038694
Colonoscopic
Polypectomy can reduces Colon Cancer Deaths
By
Anne Landry |February 27, 2012
Executive
Editor, ONCOLOGY Nurse Edition
A
multi-institutional, NCI-funded retrospective study in the New England
Journal of Medicine highlights the significant long-term benefit of
colonoscopic polypectomy in preventing death from colon cancer, with
polypectomy cutting the incidence of colon cancer–related mortality in half
compared with the general population. For the study, Ann G. Zauber, PhD, from
the department of epidemiology and biostatistics at Memorial Sloan-Kettering
Cancer Center, and coauthors aimed to evaluate the long-term effect of
colonoscopic polypectomy on mortality from colorectal cancer, by following
patients from the National Polyp Study (NPS), which showed removal of
adenomatous polyps during colonoscopy prevented colorectal cancer.
Included in the NEJM study, published
in the February 23 issue, were all patients prospectively referred for initial
colonoscopy (between 1980 and 1990) at NPS clinical centers who had adenomas
and nonadenomas. (Patients with nonadenomatous polyps served as the internal
control group.)
Using the National Death Index to identify
deaths and their causes during a follow-up period as long as 23 years, Dr.
Zauber and coauthors assessed mortality from colorectal cancer among patients
with adenomas removed, compared with patients who had nonadenomatous polyps and
with the expected incidence-based mortality from colorectal cancer in the
general population (using data from the Surveillance Epidemiology and End
Results [SEER] Program).
After a median of 15.8 years, of 2,602 NPS
patients who had adenomas removed, 1,246 had died from any cause and 12 had
died from colorectal cancer. “Given an estimated 25.4 expected deaths from
colorectal cancer in the general population, the standardized incidence-based
mortality ratio was 0.47 (95% CI, 0.26–0.80) with colonoscopic polypectomy,
suggesting a 53% reduction in mortality,” the investigators wrote.
During the first 10 years after polypectomy,
they said, mortality from colorectal cancer was similar among patients with
adenomas vs nonadenomatous polyps. In conclusion, they wrote that their study
results “support the hypothesis that colonoscopic removal of adenomatous polyps
prevents death from colorectal cancer.”
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