Health & body · 1999
Did endoscopic screening with removal reduce colorectal cancer cases?
From 1983 to 1996, colorectal cancer was registered in 2 people offered screening and 10 controls. Overall mortality was higher in the screening group, and the researchers said its possible effect on mortality should be studied in larger groups.
Details
Most colorectal cancers develop from adenomas. Polyp removal was believed to reduce colorectal cancer incidence, but the effect had not previously been explored in prospective controlled studies. The researchers aimed to evaluate that effect in a population-based screening program.
In 1983, 400 men and women aged 50–59 were randomly drawn from the population registry of Telemark, Norway. They were offered flexible sigmoidoscopy and, if polyps were found, a full colonoscopy with polyp removal and follow-up colonoscopies in 1985 and 1989. A control group of 399 people was drawn from the same registry. In 1996, both groups, then aged 63–72, were invited for colonoscopy. Hospital files and Norwegian Cancer Registry records were searched for colorectal cancer cases from 1983 to 1996.
A total of 324 people (81%) attended screening endoscopy in 1983, and 451 (71%) attended in 1996. From 1983 to 1996, colorectal cancer was registered in 2 people in the screening group and 10 in the control group (relative risk 0.2; 95% confidence interval 0.03–0.95; P = 0.02). Overall mortality was higher in the screening group: 55 deaths (14%), compared with 35 (9%) in the control group (relative risk 1.57; 95% confidence interval 1.03–2.4; P = 0.03).
The researchers concluded that endoscopic screening with polyp removal and follow-up reduced colorectal cancer incidence in a Norwegian general population. They said the possible effect of screening on overall mortality should be addressed in larger studies.
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