RSS Feeds
The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer
- Nancy N. Baxter, MD, PhD; and
- Linda Rabeneck, MD, MPH
- From St. Michael's Hospital, LiKaShing Knowledge Institute, Toronto, Ontario M5B 1W8, Canada, and Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada.
IN RESPONSE:
Our recent study investigating the association between colonoscopy and colorectal cancer mortality has generated substantial interest. The media attention in response to publication of our study has been due, at least in part, to a misinterpretation of our methodology and primary outcome. We did not evaluate the rate of missed cancer cases at colonoscopy, and the degree to which missed cancer cases (or missed precursor lesions) may have contributed to our findings—that colonoscopy is significantly associated with a reduction in mortality from left-sided colorectal cancer but not right-sided colorectal cancer—is unknown. There has been considerable speculation with respect to the influence of procedural quality in Ontario on our findings; however, our understanding of the quality of colonoscopy in the general population in any jurisdiction is limited and is almost certainly lower than that published in series from expert centers.
In addition, this line of argument reveals an unwavering …
