Patients with intestinal polyps have a lower risk of dying from cancer than previously thought, according to Norwegian researchers.
This group of patients may therefore need less frequent colonoscopic surveillance than what is common today. As a potential concequence, the researchers argue, health service resources may be diverted to other, patient groups.
The findings were released today in The New England Journal of Medicine (NEJM).
World's largest study
The Norwegian study is the world's largest of its kind, and involved following up patients over a longer time span than has previously been done.
Researchers estimated the risk of colorectal mortality in more than 40,000 Norwegian patients who had undergone removal of polyps. They were then monitored for up to 19 years. All deaths were recorded.
No higher risk
"The results indicate that patients who previously had colorectal polyps removed, do not have a higher risk of death caused by colorectal cancer than the general Norwegian population", says co-author Dr. Mette Kalager.
A public health problem
Colorectal cancer is one of the most common cancers in Norway and poses a significant public health problem. More than 3,600 new cases are registered in the country each year and the incidence has increased rapidly in recent decades.
According to current national guidelines in Norway, patients who previously have removed polyps are recommended colonoscopic screening. This is recommended because of the assumption that these patients have an increased risk of colorectal cancer.
The number of patients waiting in line for this kind screening is rapidly growing, however, eventually putting a strain on hospital resources.
Say Dr. Magnus Løberg, primary author and research team member:
"Patients with polyps may not need such a frequent colonoscopic surveillance as we have today. The resources could rather be used on symptomatic patients".
Magnus Løberg, M.D., Mette Kalager, M.D., Ph.D., Øyvind Holme, M.D., Geir Hoff, M.D., Ph.D., Hans-Olov Adami, M.D., Ph.D., and Michael Bretthauer, M.D., Ph.D.: "Long-Term Colorectal-Cancer Mortality after Adenoma Removal." N Engl J Med 2014; 371:799-807August 28, 2014. DOI: 10.1056/NEJMoa1315870