Colonoscopy and Colorectal Cancer Mortality
Authors: Sudha Xirasagar, Piet C. de Groen
Journal: Annals of Internal Medicine (2018)

Letters18 September 2018Colonoscopy and Colorectal Cancer MortalitySudha Xirasagar, PhD and Piet C. de Groen, MDSudha Xirasagar, PhDUniversity of South Carolina, Columbia, South Carolina (S.X.)Search for more papers by this author and Piet C. de Groen, MDUniversity of Minnesota, Minneapolis, Minnesota (P.C.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0296 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Kahi and colleagues (1) conclude that colonoscopy reduces colorectal cancer (CRC) mortality risk by 61%, the complement of the 0.39 odds ratio for colonoscopy exposure among patients with CRC (case patients) versus control participants matched on age and sex. Their conclusion is problematic because colonoscopy status was unreliable (the identification algorithm is 70% accurate). Furthermore, case patients were substantially more predisposed to CRC because they comprised more black persons and more persons with lower socioeconomic status, a family history of CRC, comorbidities, and a history of cigarette smoking than the control group (Table 1 of the article). ...References1. Kahi CJ, Pohl H, Myers LJ, Mobarek D, Robertson DJ, Imperiale TF. Colonoscopy and colorectal cancer mortality in the Veterans Affairs health care system: a case–control study. Ann Intern Med. 2018;168:481-8. [PMID: 29532085]. doi:10.7326/M17-0723 LinkGoogle Scholar2. Sistrom CL, Garvan CW. Proportions, odds, and risk. Radiology. 2004;230:12-9. [PMID: 14695382] CrossrefMedlineGoogle Scholar3. Xirasagar S, Li YJ, Hurley TG, Tsai MH, Hardin JW, Hurley DM, et al. Colorectal cancer prevention by an optimized colonoscopy protocol in routine practice. Int J Cancer. 2015;136:E731-42. [PMID: 25242510] doi:10.1002/ijc.29228 CrossrefMedlineGoogle Scholar4. Duloy AM, Kaltenbach TR, Keswani RN. Assessing colon polypectomy competency and its association with established quality metrics. Gastrointest Endosc. 2018;87:635-44. [PMID: 28882577] doi:10.1016/j.gie.2017.08.032 CrossrefMedlineGoogle Scholar5. Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014;370:1298-306. [PMID: 24693890] doi:10.1056/NEJMoa1309086 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of South Carolina, Columbia, South Carolina (S.X.)University of Minnesota, Minneapolis, Minnesota (P.C.D.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0296. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoColonoscopy and Colorectal Cancer Mortality in the Veterans Affairs Health Care System Charles J. Kahi , Heiko Pohl , Laura J. Myers , Dalia Mobarek , Douglas J. Robertson , and Thomas F. Imperiale Colonoscopy and Colorectal Cancer Mortality Charles J. Kahi , Heiko Pohl , Laura J. Myers , Douglas J. Robertson , and Thomas F. Imperiale Metrics 18 September 2018Volume 169, Issue 6Page: 423-424KeywordsAdenomasColonoscopyColorectal cancerDisclosureGastroenterology and hepatologyMortalitySocioeconomic statusSub-specialty careTechniciansVeteran care ePublished: 18 September 2018 Issue Published: 18 September 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...