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Followup colonoscopy in patients with a history of nonmetastatic colorectal cancer improves survival

Colorectal cancer is the second leading cause of cancer deaths in the United States, and patients who have a history of nonmetastatic colorectal cancer should have a followup colonoscopy to reduce their risk of death from this cancer, recommends this study. The researchers found that the risk of death was decreased by 43 percent in a group of patients who had at least one followup colonoscopy compared with patients who had none. Those who did not have any followup colonoscopy were 1.8 times more likely to die (from all causes) at any given point during the 5-year followup than those who had a colonoscopy.

This is the first study to demonstrate a significant survival benefit for endoscopic followup for patients with colorectal cancer, note Deborah A. Fisher, M.D., M.H.S., of Duke University Medical Center, and her colleagues. Their findings are based on an analysis of data on 3,546 patients who were listed in Veterans Affairs national databases with a new diagnosis of colorectal cancer during fiscal years 1995 and 1996.

The researchers compared 5-year mortality rates of patients who received at least one colonoscopy after their diagnosis with patients who had no further procedures, after adjusting for age, race, chemotherapy, radiation therapy, and coexisting illness. Their research was supported in part by the Agency for Healthcare Research and Quality (NRSA training grant T32 HS00079).

See "Mortality and follow-up colonoscopy after colorectal cancer," by Dr. Fisher, Amy Jeffreys, M.Stat., Steven C. Grambow, Ph.D., and Dawn Provenzale, M.D., M.S., in the American Journal of Gastroenterology 98(4), pp. 901-906.

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