Study suggests some people may wait longer for repeat colonoscopy

A new study from Germany questions whether people can wait longer than the recommended 10 years to repeat a colonoscopy after an initial negative colon cancer screening. The results showed that women and young people without gastrointestinal symptoms could extend the intervals between screenings, or opt for a less invasive method, such as a stool test.

According to CNN, the researchers looked at 120,000 people ages 65 and older who lived in Germany from 2013 to 2019 and who had had a colonoscopy 10 years or more after their initial screening. They compared their results to all colonoscopy screenings performed during that time period in individuals age 65 and older — most of whom were being screened for the first time.

In the study, published in JAMA Internal Medicine, researchers said they found 40% to 50% fewer precancerous or cancerous growths in the people who underwent repeat screenings than with all screening colonoscopies, and advanced growths or cancers in only 4% to 5% of the cases. women and 5% to 7% of men 10 years or more after a negative colonoscopy.

In light of the study findings, the authors noted that current guidelines calling for a colonoscopy every 10 years are safe, and that for women and younger people without any symptoms, the interval between colonoscopies may be extended.

Excluding skin cancer, colorectal cancer is the third most common cancer diagnosed in the US, says the American Cancer Society (ACS). The number of people diagnosed with colon or rectal cancer has generally declined since the mid-1980s, mainly because more people are being screened and their lifestyle-related risk factors are changing. But this downward trend is more true for older adults, the ACS says. In people under the age of 50, the rate has increased by 1% to 2% since the mid-1990s.

Current guidelines recommend colorectal cancer screening in all adults ages 45 to 75, says CNN. The recommendations recently changed to start screening at 45 instead of 50 in response to more younger people being diagnosed. If the screening is negative, patients will not need another colonoscopy for 10 years.

Cancer experts say the German findings are interesting, but would like more research to support their results before the guidelines are changed.

“There is good evidence that screening colonoscopy in asymptomatic individuals at 10-year intervals is effective and cost-effective,” says Dr. Robert Bresalier, a gastrointestinal oncologist at the MD Anderson Cancer Center. And I don’t think I’m ready to change yet. I wouldn’t be willing to change the practice in terms of extending the interval based on the study, but it’s reassuring and provides additional data to reinforce the concept of adhering to these guidelines.

“The overall message of this study is that we can feel comfortable with the current guidelines,” he said.

More than a quarter of eligible Americans aren’t getting screened for colon cancer, and they should, say health care advocates, as the disease is expected to claim the lives of 52,550 Americans by 2023, the ACS says.

“Right now, the biggest impact we have – and relevant to this discussion – is screening. So if you haven’t been screened and you’re in that age-relevant age group, you should get screened,” says Bresalier. “And that obviously has a bigger impact, and the biggest impact we can have right now in terms of influencing colon cancer death.”

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