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Colonoscopic polyp removal prevents cancer deaths, study says

February 22, 2012|By Eryn Brown, Los Angeles Times / For the Booster Shots blog

Colon cancer is the third deadliest cancer in the U.S.; it is expected to kill more than 51,000 Americans this year, according to the American Cancer Society. Physicians have long assumed that removing precancerous polyps during patient colonoscopies reduces the numbers of such deaths. Now researchers have proved it.

In a large, multi-decade study of more than 2,600 patients who had precancerous polyps removed during colonoscopies between 1980 and 1990, scientists at the Memorial Sloan-Ketting Cancer Center in New York and colleagues at other institutions found that removing the polyps reduced deaths from colon cancer in the group by 53%. 

An article detailing their results was published Wednesday in the New England Journal of Medicine.

“This is something that we’ve been waiting for,” said Dr. William Katkov, a gastroenterologist at Saint John’s Health Center in Santa Monica who was not involved in the study. “It made sense that removing benign precancerous growths would prevent cancer and save lives. But establishing that isn’t easy.”

Katkov said that the challenge stems from polyp growth’s long timeline — it can take years for a tiny adenoma to grow large and become malignant.  Tracking thousands of patients over 23 years, as these researchers did, requires “monumental” work, he said.

The U.S. Preventive Services Task Force recommends that most people begin getting regular colonoscopies at age 50.  Those suffering changes in bowel habits, blood in the stool or anemia may need to begin screening even sooner, Katkov said.

He added that many patients remain squeamish about the procedure (and, for that matter, in testing that looks for blood in the stool.) “The willingness to participate in screening is the largest obstacle to making an impact on incidences of colon cancer and death,” he said.

But, he added, “I think the apprehension and the anticipation is worse than the reality."

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