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Letters |2 June 2009

The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer

Amit Gupta, MD, MS; David A. Ahlquist, MD

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Author, Article, and Disclosure Information
Potential Financial Conflicts of Interest: None disclosed.
  • From Central Illinois Hematology and Oncology Center, Springfield, IL 62701; and Mayo Clinic, Rochester, MN 55905.
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Potential Financial Conflicts of Interest: None disclosed.
TO THE EDITOR:
In their recent study (1), Baxter and colleagues observed that colonoscopy was associated with a significant decrease in left-sided but not right-sided colorectal cancer mortality. If data are available, it would be instructive to report differences in polypectomy rates between case patients and control participants. In the end, it is removal of premalignant polyps, rather than colonoscopy per se, that accounts for colorectal cancer prevention.
We reported elsewhere (2) our findings from a population-based study of all colorectal cancer cases in Olmsted County, Minnesota, assessing concurrent trends in colorectal cancer incidence, screen-detection, and polypectomy rates. Over the study period (1980 to 1999), polypectomies increased 4-fold and colorectal cancer incidence decreased by 23%. The decrease in colorectal cancer incidence was accounted for by a 40% reduction in left-sided colorectal cancer (P < 0.001), because the incidence of right-sided colorectal cancer remained essentially unchanged.
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Gupta A, Ahlquist DA. The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer. Ann Intern Med. ;150:817. doi: 10.7326/0003-4819-150-11-200906020-00014

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Published: Ann Intern Med. 2009;150(11):817.

DOI: 10.7326/0003-4819-150-11-200906020-00014

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