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 23 November 2017

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News

High prevalence of colorectal cancer beyond sigmoidoscopy reach

February's American Journal of Gastroenterology recommends primary screening colonoscopy in health programs for the average-risk population, beginning at the age of 50 years, and to include elderly healthy subjects.

News image

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The role of screening colonoscopy for colorectal neoplasia in average-risk population, remains to be determined.

Professor Nadir Arber and colleagues from Israel evaluated the prevalence and anatomic location of colorectal adenoma and carcinoma.

The research team also assessed the morbidity of colonoscopy in individuals at average risk for colorectal cancer.

The team conducted a retrospective prevalence study of subjects aged 40 to 80 years who underwent a colonoscopy.

The subjects had no cancer-related symptoms, personal or family history of colorectal neoplasia.

The team enrolled 1177 persons, of which 183 were 40 to 49 years of age, 917 were 50 to 75 years, and 77 were 76 to 80 years of age.

The prevalence of overall colorectal neoplasia, advanced neoplasia, and cancer was 21%, 6%, and 1%, respectively.

In the 50 to 75 age group, the prevalence of overall adenoma was 21%
American Journal of Gastroenterology

The team found that in the 50 to 75 age group, the prevalence of overall adenoma, advanced neoplasia, and cancer was 21%, 7%, and 1%, respectively.

Of the 206 neoplasia cases, the researchers found that 21 to 43% harbored proximal neoplasia beyond the reach of sigmoidoscopy, without distal lesions.

Among the elderly, the prevalence of overall adenoma, advanced neoplasia, and cancer reached 26%, 14%, and 3%, respectively.

In the youngest of the groups, the team observed that 10% had overall neoplasia, 1% had advanced adenoma, and none had colorectal cancer.

Procedure-related morbidity rate was 0.1%, with no perforations, bleedings, or mortality.

Professor Arber's team commented, “Screening colonoscopy in average-risk subjects demonstrated a considerable prevalence of colorectal neoplasia and proximal lesions beyond the reach of sigmoidoscopy.”

“The morbidity rate was negligible.”

“Primary screening colonoscopy should be considered in health programs for the average-risk population, beginning at the age of 50 years.”

“The significantly high rate of advanced and proximal neoplasia in the elderly, encourages the inclusion of healthy subjects aged 76 to 80 years in future prospective studies.”

Am J Gastroenterol 2006: 101(2): 255
10 February 2006

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