Surgical removal of small colon polyps is costly and unnecessary

Nov 03, 2008

Polypectomy (the surgical removal of polyps by colonoscopy) of small polyps found during CT colonography is costly and unnecessary according to a study performed at the University of Wisconsin School of Medicine and Public Health in Madison, WI.

A decision analysis model was constructed to represent the clinical and economic consequences of performing three year colorectal cancer surveillance, immediate colonoscopy with polypectomy, or neither on patients who have 6-9 mm polyps found on CT colonography (CTC). The analysis model was accompanied by a hypothetical population of 100,000 60-year-old adults with 6- to 9-mm polyps detected at CTC screening.

Results showed that, "by excluding large polyps and masses, CTC screening can place a patient in a very low risk category making colonoscopy for small polyps probably not warranted," said Perry J. Pickhardt, MD, lead author of the study. "Approximately 10,000 colonoscopy referrals would be needed for each theoretical cancer death prevented at a cost of nearly $400,000 per life-year gained. We would also expect an additional 10 perforations and probably one death related to these extra colonoscopies. There may be no net gain in terms of lives—just extra costs," said Dr. Pickhardt.

"The clinical management of small polyps detected at colorectal cancer screening has provoked controversy between radiologists and gastroenterologists. Patients should be allowed to have the choice between immediate colonoscopy and imaging surveillance for one or two isolated small polyps detected at colorectal cancer screening," said Dr. Pickhardt.

CT colonography is now a recommended test for colorectal cancer screening by the American Cancer Society. "If patients with small polyps are monitored, only five percent of adults undergoing CTC screening will need to undergo immediate invasive colonoscopy," said Dr. Pickhardt.

Source: American Roentgen Ray Society

Explore further: The impact of bacteria in our guts

add to favorites email to friend print save as pdf

Related Stories

Take a bow-wow: dogs fight bowel cancer

Jan 31, 2011

Japanese researchers on Monday reported a "lab" breakthrough: a retriever which can scent bowel cancer in breath and stool samples as accurately as hi-tech diagnostic tools.

Studies examine Third Eye Retroscope during colonoscopy

Mar 18, 2010

Two new studies show an increase in polyp detection rates using the Third Eye Retroscope (TER), a retrograde viewing device, during colonoscopy. The first study found that TER added to standard colonoscopy detected 13.2 percent ...

How to increase colonoscopy attendance?

Aug 26, 2009

In view of low attendance rate for colonoscopy screening for colorectal cancer (CRC), it is necessary to establish effective intervention methods to increase colonoscopy compliance. Many studies have reported that subjective ...

Study: Many elderly get colon screening too often

May 09, 2011

(AP) -- Many older Americans get repeat colon cancer tests they don't need and Medicare is paying for it, suggests a study that spotlights unnecessary risks to the elderly and a waste of money.

Recommended for you

The impact of bacteria in our guts

21 hours ago

The word metabolism gets tossed around a lot, but it means much more than whether you can go back to the buffet for seconds without worrying about your waistline. In fact, metabolism is the set of biochemical ...

Stem cell therapies hold promise, but obstacles remain

22 hours ago

(Medical Xpress)—In an article appearing online today in the journal Science, a group of researchers, including University of Rochester neurologist Steve Goldman, M.D., Ph.D., review the potential and ch ...

New hope in fight against muscular dystrophy

23 hours ago

Research at Stockholm's KTH Royal Institute of Technology offers hope to those who suffer from Duchenne muscular dystrophy, an incurable, debilitating disease that cuts young lives short.

Biologists reprogram skin cells to mimic rare disease

Aug 21, 2014

Johns Hopkins stem cell biologists have found a way to reprogram a patient's skin cells into cells that mimic and display many biological features of a rare genetic disorder called familial dysautonomia. ...

User comments : 0