Does the NordICC trial dethrone colonoscopy for colon cancer screening?
https://doctorbuzz.substack.com/p/does-t...olonoscopy
INTRO: It’s not often in the world of cancer screening that a study comes out which merits a description like “bombshell.” This week, however, we got one: the NordICC randomized controlled trial on the benefits of colonoscopy for colorectal cancer screening. To the surprise of many (and the dismay of most gastroenterologists), no meaningful benefit was found. Does this mean we should stop recommending colonoscopies to screen people with average risk? NordICC doesn’t fully answer that question, but I do think we need to mull over what we’re doing a little harder... (MORE - details)
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‘It still prevented cancers’: Experts discuss furor over colonoscopy screening study and dissect the nuances
https://www.statnews.com/2022/10/14/colo...r-nuances/
INTRO: On Sunday, the New England Journal of Medicine published the interim results of a landmark trial examining the effect of inviting people to colonoscopy screening. The paper, which STAT covered, exploded across medical media and ignited debate over the trial’s results, how to interpret those results, and the popular coverage of the study.
The frenzy resulted over the trial’s main finding — which is that offering colonoscopies to people did not reduce cancer deaths within a 10-year period. This result jarred with the longstanding belief that this screening could almost eliminate colorectal cancers if everyone attended to it.
Even with the debate, there was some clear consensus among experts about the trial, colonoscopy screening, and colorectal cancer screening in general. The main point: colonoscopy screening can prevent colorectal cancer and cancer-related death, even if the study suggested that invitations to colonoscopy were less than convincing. There is a lot of evidence supporting colonoscopy as a procedure, and this study does not suggest otherwise. Not only did experts agree that colonoscopy screening is useful, but also that the study provided further evidence that colonoscopy can prevent cancer.
“It still prevented cancers,” said Samir Gupta, a gastroenterologist at the University of California, San Diego and the Veterans Health Administration who didn’t work on the study, “There aren’t a lot of tests that can do that.”
The other main point is that the trial did not test the efficacy of colonoscopy as a procedure, but rather it investigated how colonoscopy programs perform in the real, messy world. That’s because the trial specifically tested the difference between inviting people to do a colonoscopy versus no colonoscopy; it was not a randomized trial of people who did colonoscopy versus people who didn’t. That makes this trial more of a population or public health study... (MORE - details)
https://doctorbuzz.substack.com/p/does-t...olonoscopy
INTRO: It’s not often in the world of cancer screening that a study comes out which merits a description like “bombshell.” This week, however, we got one: the NordICC randomized controlled trial on the benefits of colonoscopy for colorectal cancer screening. To the surprise of many (and the dismay of most gastroenterologists), no meaningful benefit was found. Does this mean we should stop recommending colonoscopies to screen people with average risk? NordICC doesn’t fully answer that question, but I do think we need to mull over what we’re doing a little harder... (MORE - details)
- - - - - - - - - -
‘It still prevented cancers’: Experts discuss furor over colonoscopy screening study and dissect the nuances
https://www.statnews.com/2022/10/14/colo...r-nuances/
INTRO: On Sunday, the New England Journal of Medicine published the interim results of a landmark trial examining the effect of inviting people to colonoscopy screening. The paper, which STAT covered, exploded across medical media and ignited debate over the trial’s results, how to interpret those results, and the popular coverage of the study.
The frenzy resulted over the trial’s main finding — which is that offering colonoscopies to people did not reduce cancer deaths within a 10-year period. This result jarred with the longstanding belief that this screening could almost eliminate colorectal cancers if everyone attended to it.
Even with the debate, there was some clear consensus among experts about the trial, colonoscopy screening, and colorectal cancer screening in general. The main point: colonoscopy screening can prevent colorectal cancer and cancer-related death, even if the study suggested that invitations to colonoscopy were less than convincing. There is a lot of evidence supporting colonoscopy as a procedure, and this study does not suggest otherwise. Not only did experts agree that colonoscopy screening is useful, but also that the study provided further evidence that colonoscopy can prevent cancer.
“It still prevented cancers,” said Samir Gupta, a gastroenterologist at the University of California, San Diego and the Veterans Health Administration who didn’t work on the study, “There aren’t a lot of tests that can do that.”
The other main point is that the trial did not test the efficacy of colonoscopy as a procedure, but rather it investigated how colonoscopy programs perform in the real, messy world. That’s because the trial specifically tested the difference between inviting people to do a colonoscopy versus no colonoscopy; it was not a randomized trial of people who did colonoscopy versus people who didn’t. That makes this trial more of a population or public health study... (MORE - details)