Colorectal Cancer Screening Study Looks at the Use of Colonoscopy

By Oscar

Katie Couric of NBC’s “Today Show” had one — should you? The procedure is a colonoscopy, a medical test used to screen for colorectal cancer, the second leading cause of cancer death in the United States. A study published in the July 20 issue of the New England Journal of Medicine evaluates the use of colonoscopy as a primary screening procedure in patients, like Couric, who have no symptoms.

Standard screening recommendations for colorectal cancer (CRC) currently include periodic sigmoidoscopy, a test that uses a sigmoidoscope (a long, thin tube with a camera on the tip) to see inside the rectum and the lower colon, for patients over 50. Colonoscopy is similar to sigmoidoscopy, but uses a colonoscope that lets the doctor see the inside of the rectum and entire colon. Colonoscopy, a more invasive procedure often not covered by insurance companies, is typically recommended only when a patient is at higher risk for CRC or already has positive test results. Study findings, however, indicate that a colonoscopy can detect cancer in patients without symptoms that would be missed if the doctor performed sigmoidoscopy instead.

Researchers from six Veterans Affairs medical centers in the United States enrolled 3,196 patients in the study. Ninety-seven percent of the patients in the study were men and 98 percent underwent colonoscopic examination. None of the patients had symptoms at the beginning of the study. There was no evidence of cancer in 62.5 percent of the patients tested.

With either preventive screening technique, cancer is detected earlier and treatment is more likely to be effective. Sigmoidoscopy, however, does not reveal as much of the colon as colonoscopy. As a result, it only detects cancer in the distal (lower) colon and not in the proximal (upper) colon. In this study, results show that 52 percent of the patients with proximal cancer did not have signs of distal cancer. Thus, doctors would most likely miss cancer in these patients if they used sigmoidoscopy instead of colonoscopy to screen for colon and rectal cancers.

The authors note that the study has its limitations. For example, it was based primarily on men and a disproportionate number of participants had a family history of colorectal cancer. The researchers also state that it needs to be determined if colonoscopy reduces the death rate from colorectal cancer more so than other screening methods.

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categoriaCancer commentoComments Off dataDecember 15th, 2011

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