After a normal colonoscopy when no polyps are found, guidelines call for a repeat test in 10 years.

However, almost half of Medicare patients with a negative colonoscopy got another exam within 7 years, and for one in four there was no clear evidence that they needed one.

Because colonoscopies have real risks and are expensive, over-testing can be both dangerous and costly. Given limited numbers of physicians who do colonoscopies, unecessary procedures add to long waiting lists for screening and for necessary follow-up exams.

Although Medicare regulations call for reimbursement only after 10 years in cases where the first procedure didn’t find a problem, payments are being made for earlier exams.  In fact, Medicare denied payment for only 2 percent of colonoscopies for which there was no clear indication of need. Read the rest of this entry »

Watch Nancy Roach tell AACR members and advocates how they can join the effort for cancer research funding.

Speaking at the 2011 annual meeting of the American Association for Cancer Research, Nancy said,

If public funding for biomedical research matters to you, get involved.

Nancy represented the voice of advocates in an AACR discussion of The Outlook for Cancer Research Funding in the Coming Years: The Importance of Advocacy and Government Relations.

She was joined by former Illinois Congressman John Edward Porter, Shannon K. Bell from the NCI Office of Advocacy Relations, and Jon G. Retzlaff who is the managing director of Science Policy and Government Affairs for AACR.

You can also hear John Edward Porter and Shannon Bell on the AACR website.

Digestive Disease Week  2011 Update

Although many studies show that men have more adenomas (pre-cancerous polyps) than women, there is no difference in rates of colorectal cancer between men and women.

Could this be because women have polyps that are harder to detect during screening and so aren’t removed in time to prevent cancer?

That was the question that Dr. Joseph Anderson at the University of Connecticut asked. Read the rest of this entry »

Digestive Disease Week 2011 Update

Finding colorectal cancer patients with Lynch syndrome helps both patients and their families to prevent cancer.

Lynch patients are at high risk for a second or third colon cancer, so identifying them before their colorectal surgery may change the operation planned.  Surgeons may want to remove the entire colon to prevent another colon cancer, and women may choose to have a hysterectomy during the same surgery to prevent endometrial cancer.

Because young patients are more likely to have Lynch syndrome, pathologists at the Mayo Clinic tested tumors from patients 50 years old or younger for microsatellite instability (MSI) after their surgery if they had not been tested preoperatively. Read the rest of this entry »

Some colorectal cancer patients will have their cancer spread into the tissue within their abdomen or to the surfaces of abdominal organs.  This condition, called peritoneal carcinomatosis, can be treated successfully if it is recognized early.  Unfortunately, it is often not seen on routine scanning and not diagnosed when surgical treatment is possible.

A clinical trial at the NIH Clinical Center in Bethesda will see if a second surgery to look for peritoneal carcinomatosis in high-risk patients can find the disease earlier, treat it appropriately, and  improve survival.

Eligible patients for the trial will have already had surgery that removed all visible tumor and are considered to have no evidence of disease (NED). However, their cancer will have some high-risk features that makes it more likely that they might develop peritoneal carcinomatosis in the future.

The trial is not intended for patients who already have peritoneal carcinomatosis. Read the rest of this entry »