Colonoscopy has its Limits (Ivanhoe)

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(http://www.ivanhoe.com/channels/p_printStory.cfm?storyid=20371) Reported

December 17, 2008

Colonoscopy has its Limits

(Ivanhoe Newswire) -- Colonoscopy has been credited with preventing many

cases of colon cancer, but the test may not be catching as many pre-cancerous

polyps as doctors thought.

According to researchers who reviewed health records of people who did and

did not die of colorectal cancer, the test is clearly linked to a reduction in

cancer deaths for left-sided colon cancers. But almost no effect was seen on

cancers that developed on the right side of the colon.

" Colonoscopy is an effective intervention, " F. Ransohoff, M.D., who

wrote an editorial accompanying the study, was quoted as saying. " The study

results, however, should caution physicians about saying that colonoscopy will

reduce the risk of dying from colorectal cancer by 90 percent. A 60 to 70

percent risk-reduction rate seems more reasonable. "

Why would colonoscopy be better at preventing left-sided cancers than

right-sided cancers? The authors speculate some colonoscopies billed as

" complete "

may not actually be looking at the total right colon. Alternatively, it could

be that bowel preparation isn’t as good in the right colon, making it more

difficult for doctors to spot pre-cancerous polyps, or polyps in the right

colon might be flatter and thus more difficult to see and remove during the

test. Right-sided polyps may also grow more quickly and thus be more dangerous.

" Although improvements in the quality of screening colonoscopy may improve

detection at the right side, differences in tumor biology may limit the

potential to prevent right-sided colorectal cancer deaths with current

endoscopic

technology, " continues Dr. Baxter. " Nevertheless, this study clearly

demonstrates that colonoscopy is an effective procedure for the prevention of

death

from colorectal cancer, it just may not be quite as effective as we’ve

thought

in the past. "

SOURCE: ls of Internal Medicine, published online December 15, 2008

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President

MA Lyme & Tick-Borne Disease Awareness Association

Mashpee, MA