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In early October of this year, you may have seen a story making the rounds that suggested that a new landmark study published in the New England Journal of Medicine suggests the benefits of colonoscopies for cancer screening might be overestimated.
I recently sat down with a local gastroenterologist here in Colorado Springs who wanted to pump the brakes on this story and remind us of a few important things when it comes to colon cancer screenings and preventing cancer deaths.
Dr. Kendall Mann, MD is a board-certified gastroenterologist with Gastroenterology Associates in Colorado Springs. Dr. Mann tells me the study is flawed, it’s not really applicable to the population in the United States, and having a colonoscopy when it’s recommended for you remains the gold standard of care for early detection and treatment of colon cancer to save lives.
I asked Dr. Mann, “You guys must cringe when you see a major U.S. news outlet come out and say that colonoscopies might not be as effective?”
He replied, “I wanted to put the word out that it (this study) hasn't really changed things. It's a flawed study so this does not change the importance or the value of having a colonoscopy. It's still the gold standard. It saves lives and this is the only colon cancer test that can screen, detect and prevent colorectal cancer.”
There were several points about the study Dr. Mann says are important to note. “This study was done in several countries in northern Europe and involved about 85,000 people. Only one-third of the participants were invited to have a colonoscopy and the other two-thirds had standard care. Of those who were invited to have a colonoscopy, only 42% of those folks opted to have the procedure. That's important because when we look at how they calculated the effectiveness of colonoscopy on colon cancer, one has to know that the data was limited because only a percentage of folks actually went through having a colonoscopy, so that's one of the big flaws with this study.”
Besides the fact that not all participants of the study were invited to have a colonoscopy, Dr. Mann says it’s important to note that the study was not performed in the United States. “Another type potential flaw in this study is how applicable is it to us here in the United States. The study was done in Norway, Sweden, and Poland, and those populations are different from the diverse population here in the United States. It also doesn't include the communities of color here that we have because there's increased incidence and death rates from colon cancer that are higher in that population.”
Dr. Mann says actually, depending on how you look at the study, it actually indicates the opposite of how the story was headlined in October. “The study showed that colonoscopy was effective in those who had it. Colonoscopy reduced the incidence of colorectal carcinoma by 31% and reduced the risk of dying from colon cancer in 50% of folks in this study. The study also reinforced the obvious idea that if you don't have a colonoscopy it's not helpful. I also want to point out that there have been other studies that have shown that colonoscopy prevents cancer deaths.”
So the message remains clear: if you want to be proactive about your health when it comes to cancer, be up to date on all screenings that are appropriate for you - including a colonoscopy.
Dr. Mann says when it comes to colon cancer, “It's common cancer, it's preventable, and we need to get out there and have people get their colonoscopy exam so we can try to keep people away from colon cancer.”
If you want to read more details about why the American College of Gastroenterology says the results of this study shouldn’t lead you to think you can skip a needed colonoscopy, Dr. Mann says.
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