The 17-year follow-up results show that colonoscopy screening is related to a significant reduction in the incidence and mortality of colorectal cancer!

Introduction Colorectal cancer (CRC) is the third most common cancer in the world, with more than 1.
8 million new cancer diagnoses each year.

Therefore, early detection and early treatment are of great significance.

At present, in CRC screening methods, sigmoidoscopy (FS) and colonoscopy are the main options.

The advantage of colonoscopy over FS is that it can prevent not only distal CRC, but also proximal CRC.

This study aims to evaluate the association between the use of colonoscopy screening in population-based cohort studies and the overall and site-specific CRC incidence and mortality.

Research methods Researchers from Germany conducted a prospective cohort study, including 9207 subjects from the whole state of Saarland, Germany, aged 50-75 years and no history of CRC, and conducted them for 2 years , 5 years, 8 years and 17 years of follow-up.

The results of the study were followed up for a median of 17.
2 years.
The researchers observed that 268 subjects were diagnosed with CRC and 98 died of CRC.

Colonoscopy screening is associated with a significant reduction in the incidence of CRC [adjusted hazard ratio (aHR) 0.
44, 95%CI 0.
33–0.
57] and mortality (aHR 0.
34, 95% CI 0.
21–0.
53); at the same time, colonoscopy screening The incidence of posterior distal CRC (aHR 0.
36, 95% CI 0.
25– 0.
51) and mortality (0.
33, 95% CI 0.
19 – 0.
59) decreased more than the incidence of proximal CRC (aHRs 0.
69, 95% CI 0.
42–1.
13) And mortality (0.
62, 95% CI 0.
26 – 1.
45).Table 1 Changes in overall and specific site CRC incidence and mortality after colonoscopy screening.
However, within 10 years after colonoscopy screening, a significant reduction in the mortality of proximal CRC was also observed (aHR 0.
31, 95%CI 0.
10 –0.
96).

Discussion The advantage of this study lies in the long-term follow-up of a large number of people, and multiple follow-ups can update the exposure of the population.

In the follow-up process, the comprehensive collection of data will also help to carefully adjust the relevant potential confounding factors.

The limitation lies in the lack of diagnostic information about colonoscopy.
In addition, despite the large overall size of the group, the number of CRC cases and deaths is still small, hindering specific high-risk subgroups (such as those with a family history of CRC) Further analysis.

Conclusion Based on the above results, in this prospective cohort study in Germany, colonoscopy screening was associated with a significant reduction in the incidence and mortality of CRC.

The findings highlight the great potential of colonoscopy screening in preventing and reducing the incidence and mortality of distal colon and rectal CRC (and even overall CRC).

At the same time, the researchers also emphasized the need for further efforts to prevent proximal CRC more effectively.

Yimaitong compiled and compiled from: Feng G, Chen C, Bernd H, et al.
Strong Reduction of Colorectal Cancer Incidence and Mortality After Screening Colonoscopy: Prospective Cohort Study From Germany[J].
Am J Gastroenterol,2021,116(5) :967-975.