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Colorectal cancer and precursor lesions in total colonoscopy

The latest issue of the European Journal of Gastroenterology & Hepatology investigates the prevalence of colorectal cancer and its precursor lesions in symptomatic and asymptomatic patients undergoing total colonoscopy.

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Colorectal cancer is the second most common cancer in Germany.

Screening colonoscopies have been offered in Germany since 2002.

However, validation of screening programs for Colorectal cancer  relies on estimates up to date.

Dr Blumenstein and colleagues analyzed the influence of tumor-suspicious symptoms on the prevalence of colorectal cancer and its precursor lesions in patients at least 55 years of age undergoing colonoscopy in comparison with an age-matched and sex-matched control population undergoing screening colonoscopy.

The team performed a multicenter, prospective, controlled colonoscopy study.

The research team assessed the integrated care program of 49 gastroenterological practices in collaboration with a health insurance company and the screening colonoscopy program in Hesse, Germany.

In total, 1075 symptomatic and 5375 asymptomatic participants were matched for age and sex from 2008 to 2010.

Polyps were found significantly less often in symptomatic patients
European Journal of Gastroenterology & Hepatology

The team of doctors identified colorectal cancer, and its precursor lesions.

Overall, the prevalence of colorectal cancer  was significantly equivalent in both the symptomatic and the control group confidence interval for the difference, respectively.

The doctors observed advanced adenomas in significantly fewer symptomatic patients compared with 432/5375 matched asymptomatic screening participants.

Finally, polyps were found significantly less often in symptomatic patients than in matched screening participants.

Dr Blumenstein's team commented, "The results underline the importance of screening the symptom-free population at least 55 years of age to prevent colorectal cancer."

Eur J Gastroenterol Hepatol 2013: 25(5): 556-561
18 April 2013

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