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If one’s first colonoscopy results show a negative finding for colorectal cancer, the second colonoscopy can be done 15 years later

2024.05.18 07:49:44 Jimin Jun

[Photo Credit to Pexels]

A recent research paper titled: “Longer Interval Between First Colonoscopy With Negative Findings for Colorectal Cancer and Repeat Colonoscopy” by Trasias Mukama, reveals that the interval between colonoscopy screenings could potentially be extended from 10 to 15 years for individuals without a family history of CRC who obtained a negative result on their first colonoscopy.

Colon cancer is the second leading cause of cancer-related deaths worldwide.

In 2020, more than 1.9 million new cases of colorectal cancer and more than 930,000 deaths due to colorectal cancer were estimated to have occurred worldwide.

By 2040, the burden of colorectal cancer will increase to 3.2 million new cases per year (an increase of 63%) and 1.6 million deaths per year (an increase of 73%). The risk of colorectal cancer increases with age. Most cases affect people over 50 years old.

For these reasons, each country includes a colonoscopy as part of health screenings to lower the incidence of colorectal cancer. A colonoscopy is used as a method of screening to detect colorectal cancer at an early stage, but health policies vary by country, so it is included in health check-ups at intervals of 2, 5, or 10 years.

However, according to the study, if there is no family history and the colonoscopy shows a negative result for colorectal cancer, extending the current testing interval to perform a second test to 15 years would be safe.

Individuals in Sweden who had negative results for CRC on their first colonoscopy between 1990 and 2016 at ages of 45 to 69 were tracked in order to investigate when colorectal cancer was detected and how the mortality rate changed after detection.

A cohort of 110,074 individuals without a family history of CRC who had negative results on their first colonoscopy (exposed group) showed lower risks of CRC and CRC-related mortality for 15 years.

Extending the screening interval from 10 to 15 years could miss only 2 cases of CRC and 1 CRC-related death per 1,000 individuals.

This cohort study found that the interval between colonoscopy screenings could potentially be extended from 10 to 15 years for individuals without a family history of CRC who had a negative result on their first colonoscopy. Extending the interval between colonoscopy screenings could avoid unnecessary examinations.

The study compared these individuals with over 1 million people in a control group. Considering family history, research showed that after an initial negative colonoscopy, the likelihood of a future colorectal cancer diagnosis was roughly the same for those who underwent a colonoscopy every 10 years and those who extended the interval to 15 years.

Colonoscopies may cause side effects.

Since air is introduced into the intestines for observation, you may experience changes in bowel movement or discomfort. Eating too much or consuming spicy food on the day of the examination can cause abdominal pain, so one must be very cautious.

Severe abdominal pain or fever, large amounts of black or bloody stool, along with dizziness, rapid heartbeat, or cold sweats may indicate complications such as intestinal perforation, gastrointestinal bleeding, infection, or cardiovascular complications.

The average cost of a colonoscopy in the U.S. is known to be $2,750, but the cost can vary from $670 to $4,000 depending on the type of insurance, and it can be a financial burden to patients.

If a 15-year interval between colonoscopies shows no significant difference in colorectal cancer incidence compared to 10-year, 5-year, or 2-year intervals, it is hopeful news for patients because it may reduce their costs and lessen the need to undergo frequent colonoscopies with unnecessary risks.

Jimin Jun / Grade 8
Unjung middle school