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Colorectal cancer mortality prevented by use and attributable to nonuse of colonoscopy.

Abstract：

BACKGROUND:Use of colonoscopy is thought to reduce colorectal cancer (CRC) mortality, but its impact at the population level is unclear. OBJECTIVE:To estimate the effect of current colonoscopy use on CRC mortality and its further potential in reducing CRC mortality. DESIGN:Population-level analysis was performed by using the concepts of prevented and attributable fractions, by using data from the National Health Interview Survey, the Surveillance, Epidemiology and End Results Program, and estimates of the effectiveness of colonoscopy at reducing CRC mortality. SETTING:The 2005 U.S. population aged 50 years and older. EXPOSURE:Colonoscopy within 10 years or less. MAIN OUTCOME MEASUREMENTS:Percentages and absolute numbers of CRC deaths prevented and potentially preventable by colonoscopy. LIMITATIONS:Uncertainty in effectiveness estimates. RESULTS:Overall, the proportions of CRC deaths in 2005 prevented by colonoscopy (ie, the prevented fractions) range from 13% (95% CI, 11%-15%) to 19% (95% CI, 12%-24%) across the estimates of colonoscopy effectiveness. Corresponding numbers of CRC deaths prevented range from 7314 (95% CI, 6010-8467) to 11,711 (95% CI, 7077-14,898). The proportions of CRC deaths attributable to nonuse of colonoscopy (ie, the attributable fractions) range from 28% (95% CI, 22%-33%) to 44% (95% CI, 24%-60%), depending on the assumed effectiveness. Corresponding numbers of CRC deaths attributed to nonuse of colonoscopy range from 13,796 (95% CI, 11,076-16,255) to 22,088 (95% CI, 12,189-29,947). CONCLUSIONS:Although we estimate that colonoscopy has prevented substantial numbers of CRC deaths, many more deaths could have been prevented with more widespread use. These findings highlight the potential benefits from public health interventions to increase the use of screening colonoscopy.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Stock C,Knudsen AB,Lansdorp-Vogelaar I,Haug U,Brenner H

doi

10.1016/j.gie.2010.12.005

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

435-443.e5

issue

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(10)02422-3

journal_volume

pub_type

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Colorectal cancer mortality prevented by use and attributable to nonuse of colonoscopy.