UNC: Colonoscopy follow-ups can wait
Published: Thu, Sep. 18, 2008 12:30AM
Modified Thu, Sep. 18, 2008 05:23AM
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closePeople who show no signs of cancer during a colonoscopy screening do not need a follow-up scan five years later, scientists at UNC-Chapel Hill reported today.
Although experts recommend a second screening after 10 years, in practice, many doctors have their patients come back sooner. The UNC-CH finding should bolster the expert advice -- something greeted with relief by patients, who often dread the prospect of undergoing the invasive test.
"I think it's good news," said Pam Pearce of Hillsborough, who had her first colonoscopy four years ago at 50. "The better news would be if you need only one in your life."
THE PROCEDURE
What is a colonoscopy? It's a test that uses a lighted scope to find cancerous growths in the rectum and colon.
How accurate is it? It's considered the most sensitive test, compared with blood tests and less-invasive procedures, including CT colonoscopy.
What are the drawbacks? Some patients experience discomfort, but the main issue is the preparation. A day before the test, patients must drink a saltwater potion to clear out the bowels. They're also given sedation and must miss a day of work. The test carries a risk of the scope causing a tear or bleeding.
Is it expensive? It can run about $1,000. Some insurance covers it. Medicare will pay for one every 10 years, or biannually for people who are at high risk of colon cancer.
How common is colorectal cancer? It's the third most common type of nonskin cancer for men and women in the U.S. Only lung cancer is more deadly. More than 147,000 new cases of colorectal cancer are diagnosed a year, resulting in 57,000 deaths.
SOURCE: NATIONAL CANCER INSTITUTE, CENTERS FOR MEDICARE & MEDICAID SERVICES
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The study, published today in the New England Journal of Medicine, was the first to follow a large group of patients through the initial test, then conduct a follow-up. It found that the vast majority of participants who showed no signs of cancer in their first screening were also clear five years later.
"Tests can be used too often," said Dr. David Ransohoff, a professor at UNC-CH and co-author of the study. "Docs and patients are unwilling to accept any risk [of cancer]. But it may not benefit patients very much for the effort and cost and risk" of the test.
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