Colonoscopy Every 20 Years Sufficient for Early Cancer Detection?
For early colon cancer detection, experts recommend to have a colonoscopy every ten years, provided no precancerous growths are found. Results of a study conducted by Professor Hermann Brenner of the Division of Clinical Epidemiology and Aging Research of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) suggest that much longer intervals may be sufficient.
Persons whose initial screening colonoscopy revealed no precancerous lesions in the bowel have a considerably lower risk of getting colon cancer even 20 years later compared to persons who refrain from having a colonoscopy. Professor Hermann Brenner and his colleagues believe that in such cases it is sufficient to repeat the exam after 20 years. This would mean cost savings for the healthcare system and less stress for patients. The scientists hope that it would thus become possible to make this exam accessible to the whole population even in countries with limited resources.
Brenner investigated at what intervals it makes sense to repeat a screening colonoscopy. With the support of 22 hospitals in the Rhine-Neckar region he evaluated the data of 865 persons. Of these, 380 suffered from colon cancer, 485 were randomly chosen and constituted the control group. Brenner studied how the colon cancer risk developed over the years following a colonoscopy. The study included subjects who were older than 30 years and in whom a colonoscopy had revealed no abnormalities. The scientists discovered that up to 20 years later this group of persons is affected by colon cancer about 70 percent less frequently than the control group without a screening colonoscopy. In Brenner’s opinion, it is sufficient for these persons to repeat the exam after 20 years. If an initial colonoscopy is performed at a later age, a negative test result might even make another colonoscopy unnecessary. If precancerous growths are found, a follow-up exam at a shorter interval, usually after three years, is absolutely necessary.
Colonoscopy, i.e. the examination of the bowel with a colonoscope, has been part of the colon cancer screening program in Germany since October 2002. During a colonoscopy, doctors can detect and remove tumors and precancerous polyps. The statutory health insurance pays for this exam in persons 55 years and older every ten years.
The article was published online in the journal Gut / DOI: 10.1136/gut.2005.087130
Brenner H, Chang-Claude J, Seiler CM, Stürmer T, Hoffmeister M.: Does a negative screening colonoscopy ever need to be repeated?
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