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News

Colonoscopy detects cancer more in men than women

Screening with colonoscopy detects colorectal cancer at a higher rate in men than in women, finds this week's issue of the New England Journal of Medicine.

News image

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Recommendations for colorectal-cancer screening are based solely on age and family history of cancer, not sex.

Dr Jaroslaw Regula and colleagues from Poland performed a cross-sectional analysis of the data from a large colonoscopy-based screening program.

The screening program included 50,148 participants who were 40 to 66 years of age.

People 40 to 49 years of age were eligible only if they had a family history of cancer of any type.

Advanced neoplasia was detected in 6% of participants 50 to 66 years of age
New England Journal of Medicine

Of the 43,042 participants 50 to 66 years of age, 13% reported a family history of colorectal cancer.

The team also noted that 66% of the 7106 participants who were 40 to 49 years of age reported a family history of colorectal cancer.

The research team defined advanced neoplasia as cancer or adenoma that was at least 10 mm in diameter.

High-grade dysplasia, or villous or tubulovillous histologic characteristics, or any combination thereof was defined as advanced cancer.

The researchers used multivariate logistic regression to identify associations between participants' characteristics and advanced neoplasia in a primary data set.

The team confirmed the associations in a secondary data set.

Advanced neoplasia was detected in 6% of participants 50 to 66 years of age and in 3% participants 40 to 49 years of age.

The researchers observed that the rate of complications during colonoscopy was less than 1%, and no participants died.

In the validation set, the researchers showed that male sex was independently associated with advanced neoplasia.

In each age group, the number of persons to undergo colorectal-cancer screening in order to detect one advanced neoplasia was lower in men than in women.

Dr Regula's team concludes, “We detected advanced neoplasia at a significantly higher rate in men than in women, which may warrant refinement of the screening recommendations for colorectal cancer.”

NEJM 2006: 355(18):1863-72
03 November 2006

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