The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer
Authors: Joseph Romagnuolo
Journal: Annals of Internal Medicine (2009)

Letters2 June 2009The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal CancerJoseph Romagnuolo, MD, MSc, Alan N. Barkun, MD, CM, MSc, and Amee R. Manges, MSc, PhDJoseph Romagnuolo, MD, MScFrom Medical University of South Carolina, Charleston, SC 29403, and McGill University, Montreal, Quebec H3A 2T5, Canada., Alan N. Barkun, MD, CM, MScFrom Medical University of South Carolina, Charleston, SC 29403, and McGill University, Montreal, Quebec H3A 2T5, Canada., and Amee R. Manges, MSc, PhDFrom Medical University of South Carolina, Charleston, SC 29403, and McGill University, Montreal, Quebec H3A 2T5, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-11-200906020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Baxter and colleagues (1) concluded that the effect of colonoscopy on death from colon cancer (particularly right-sided disease) was weaker than previously thought. However, we feel the study design introduced significant bias, specifically in terms of the definition of control participants. Had the outcome been development of colon cancer (rather than death from colon cancer), elimination of patients with nonfatal colon cancer from the control group would have been appropriate. However, because the study outcome was death, only patients who died of colon cancer should have been excluded from the control group, regardless of whether persons with ...References1. Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L. Association of colonoscopy and death from colorectal cancer. Ann Intern Med. 2009;150:1-8. [PMID: 19075198] LinkGoogle Scholar2. Weiss NS. Application of the case-control method in the evaluation of screening. Epidemiol Rev. 1994;16:102-8. [PMID: 7925719] CrossrefMedlineGoogle Scholar3. Knox G. Case-control studies of screening procedures. Public Health. 1991;105:55-61. [PMID: 2008504] CrossrefMedlineGoogle Scholar4. Cronin KA, Weed DL, Connor RJ, Prorok PC. Case-control studies of cancer screening: theory and practice. J Natl Cancer Inst. 1998;90:498-504. [PMID: 9539244] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Joseph Romagnuolo, MD, MSc; Alan N. Barkun, MD, CM, MSc; Amee R. Manges, MSc, PhDAffiliations: From Medical University of South Carolina, Charleston, SC 29403, and McGill University, Montreal, Quebec H3A 2T5, Canada.Disclosures:Consultancies: J. Romagnuolo (Olympus), A.N. Barkun (Olympus). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociation of Colonoscopy and Death From Colorectal Cancer Nancy N. Baxter , Meredith A. Goldwasser , Lawrence F. Paszat , Refik Saskin , David R. Urbach , and Linda Rabeneck The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer Nancy N. Baxter and Linda Rabeneck The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer Jordan J. Karlitz The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer Sanford D. Markowitz , Steven H. Itzkowitz , and Barry M. Berger The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer Amit Gupta and David A. Ahlquist The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer Noel S. Weiss and V. Paul Doria-Rose The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer Stephen M. Picca The Effectiveness of Colonoscopy in Reducing Mortality From Colorectal Cancer Perry J. Pickhardt , David H. Kim , and Cesare Hassan Metrics Cited byObservational methods to assess the effectiveness of screening colonoscopy in reducing right colon cancer mortality risk: SCOLARColorectal cancer mortality prevented by use and attributable to nonuse of colonoscopyThe Reduction in Colorectal Cancer Mortality After Colonoscopy Varies by Site of the CancerLa coloscopie en France en 2008: résultats de l’enquête de deux jours d’endoscopie en France 2 June 2009Volume 150, Issue 11Page: 819KeywordsColonColonoscopyColorectal cancerFlexible sigmoidoscopyHemorrhageHereditary nonpolyposis colorectal cancerInpatientsMortalityOdds ratioOutpatients ePublished: 2 June 2009 Issue Published: 2 June 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...