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Colonoscopy risks 'justifiable' in colon cancer screening

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A German study to assess the safety of the colonoscopy has concluded that the risks are small enough to justify using the method as an effective way of screening for colon cancer.

Regular screening is seen as an effective means of preventing colon cancer compared with other types of cancer because it progresses slowly.

It typically takes many years for a precancerous lesion to turn into a dangerous carcinoma and lesions can be easily detected in a colonoscopy and removed during the same procedure.

Since 2002 the colonoscopy has been part of the national statutory cancer screening programme in Germany for all insured persons aged 55 or above.

However, just a fifth of eligible people make use of the programme and this is believed to be due to various reasons, including a fear of an unpleasant procedure potentially with complications and a fear of receiving a frightening diagnosis.

Professor Hermann Brenner of DKFZ and lead author Christian Stock looked at data from more than 30,000 individuals who had undergone outpatient colonoscopy between 2001 and 2008 to find out how common side effects are from the procedure.

Their findings are published in the journal Gastrointestinal Endoscopy.

The professor said it is crucial that health professionals, as well as patients, are well informed about the risks of complications associated with colonoscopy.

Professor Brenner and the team discovered that intestinal bleeding requiring hospital referral occurred after no more than approximately five in 10,000 colonoscopies.

They found that intestinal wall injuries were also very rare, occurring less than once in 1,000 examinations.

Deaths and non-local complications, such as strokes or myocardial infarctions, were found to be no more common in the colonoscopy group than in the control group.

In summary, the researchers said the overall risk of complications is within an expected range and they concluded that such a risk is justifiable as it is outweighed by the significant benefits of screening.

Professor Brenner revealed that the rare serious local complications took place more often than not when a large polyp is detected and removed during a colonoscopy.

“But these are the cases where patients profit most from colonoscopy, which may have saved their lives,” he added.





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