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The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer
- Joseph Romagnuolo, MD, MSc;
- Alan N. Barkun, MD, CM, MSc; and
- Amee R. Manges, MSc, PhD
- From Medical University of South Carolina, Charleston, SC 29403, and McGill University, Montreal, Quebec H3A 2T5, Canada.
TO THE EDITOR:
Baxter and colleagues (1) concluded that the effect of colonoscopy on death from colon cancer (particularly right-sided disease) was weaker than previously thought. However, we feel the study design introduced significant bias, specifically in terms of the definition of control participants. Had the outcome been development of colon cancer (rather than death from colon cancer), elimination of patients with nonfatal colon cancer from the control group would have been appropriate. However, because the study outcome was death, only patients who died of colon cancer should have been excluded from the control …
