Higher Quality Screening Colonoscopies Associated With Lower Risk of Colorectal Cancer Death, Without Higher Overall Costs
Rockville, MD - An analysis that included information from more than 57,000 screening colonoscopies suggests that higher adenoma detection rates may be associated with up to 50 percent to 60 percent lower lifetime colorectal cancer incidence and death without higher overall costs, despite a higher number of colonoscopies and potential complications, according to a study in the June 16 issue of JAMA.
Screening colonoscopy reduces colorectal cancer death risk through detection and treatment of early cancerous or precancerous lesions (adenomas) but its effectiveness depends on examination quality, which is measured by adenoma detection rates (ADRs). This rate varies widely among physicians, with unknown consequences for the cost and benefits of screening programs, according to background information in the article.
Reinier G.S. Meester, M.Sc., of Erasmus MC University Medical Center, Rotterdam, the Netherlands, and colleagues estimated the lifetime benefits, complications, and costs of an initial colonoscopy screening program at different levels of adenoma detection. The researchers performed microsimulation modeling with data from a large, community-based health care system on ADR variation and cancer risk among 57,588 patients examined by 136 physicians from 1998 through 2010. For this study, no screening was compared with screening initiation with colonoscopy according to ADR quintiles. Adenoma detection rates, the proportion of a physician’s screening colonoscopies that detect at least 1 histologically confirmed adenoma, ranged from 7.4 percent to 53 percent, with the rates increasing from quintile 1 to quintile 5. Continue>
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