Study suggests colonoscopy guidelines need to be revised

Nov 2 2006

According to a new study the polyps in the colon which are often a precursor to colon cancer are 73 percent more common in men than in women.

The finding has led the researchers to suggest that colorectal cancer screening guidelines need to be revised and women might want to start their screening at a later age.

The study by researchers at the Maria Sklodowska-Curie Memorial Cancer Center in Warsaw, Poland, looked at data on more than 50,000 volunteers between the age of 40 to 60 years who were screened for colon cancer.

It was found that almost 6 percent of participants aged 50 to 66 had advanced neoplasia (colon lesions or polyps), as did 3.4 percent of participants aged 40 to 49; but men, regardless of age, were 73 percent more likely to have advanced neoplasia than women.

The team, led by Jaroslaw Regula estimates that among people age 50 to 54, only 17 men would have to be screened to find one case of advanced neoplasia, compared to 28 women.

However the study flies in the face of conventional wisdom from cancer experts; the American Cancer Society says that colorectal cancer is just as common among women as men and around 150,000 Americans will be diagnosed with colorectal cancer this year, and more than 55,000 will die.

This makes colorectal cancer the second biggest cause of cancer death among men and women in the United States after lung cancer.

The World Health Organization says colon cancer will kill 655,000 people worldwide in just this year.

Current guidelines advise those over 40 with a family history of the disease to begin regular colonoscopy screenings, while for those with an average risk, the test should be done at regular intervals from age 50 onwards.

The researchers say it is generally accepted that the lifetime risk of colorectal cancer is similar among men and women, but their study indicates that is not the case.

However official figures suggest the lifetime colorectal cancer rates are similar between the genders.

The Polish team presented their research recently at the ACG annual meeting where it was noted that the increased use of colonoscopy and other screening has had the intended effect of a significant drop in colon cancer rates in the United States over the past two decades.

The study is published in the current issue of the New England Journal of Medicine.