Tag Archives: colonoscopy

William I. Wolff, Colonoscopy Pioneer

Dr. William Wolff died on August 20 at his home Manhattan.  He was 94. In the mid 1960′s Dr. Wolff, working with his colleague Dr. Hiromi Shinya at Beth Israel Medical Center in New York, began studying how fiber optics and a long, soft, flexible tube might make it possible to see inside the entire length of the colon.  Together they developed  the first colonoscope. In 1969, Dr. Shinya invented a wire snare and electrocautery making it possible for the team to remove polyps during a colonoscopy. By 1973, Dr. Wolff and Dr. Shinya had performed over 2,000 colonoscopies in the Endoscopy Unit at Beth Israel, demonstrating that in skilled

Poor Bowel Preps Mean Missed Polyps

When bowel preps are not good, doctors may miss almost half of adenomas (polyps) during colonoscopy.  Worse, they may miss nearly 1 in 3 large adenomas, the most worrisome kind. The bad news is that bowel prep may be suboptimal in as many of one in four patients. Because of the danger of missing an adenoma after poor bowel prep, some doctors will repeat the colonoscopy, particularly if they found at least one adenoma during the first exam.  

Some People Getting Colonoscopy Screening Too Often

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

Are Polyps Harder to Detect in Women?

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.

Get a Loved One Screened with an E-Card

Know someone who needs to be screened for colorectal cancer? Send a gentle e-reminder with a card from the American Society for Gastrointestinal Endoscopy. You can add your own message and Help Catch a Killer. Other information about colorectal cancer, screening, and colonoscopy, including videos, is available from ASGE on the Screen4ColonCancer web site.

FIT Beats All Other Screening for Effectiveness and Cost

In a computer simulation, FIT — fecal immunochemical testing — done every year saved more lives and cost the least of any colorectal cancer screening method, including colonoscopy. The computer model looked at 100,000 average risk people and compared screening methods results for number of colorectal cancer cases number of colorectal cancer deaths cost of screening and treating colorectal cancer for each screened person Compared to not screening at all, annual FIT  could save 3 out of 4 deaths from colorectal cancer. For every 100,000 people between 50 and 75, nearly 3,500 people wouldn’t get colorectal cancer, and over 1,300 wouldn’t die. Not only did FIT screening save the most

Half of Colorectal Cancer Survivors Not Getting Recommended Colonoscopies

Despite guidelines calling for a colonoscopy a year after surgery for colon or rectal cancer, less than half of patients have had one 14 months after colorectal surgery intended to cure their cancer. A study of stage I, II, and III colorectal cancer patients in the United States found that only 49 percent had received the recommended colonoscopy. Currently follow-up guidelines call for a surveillance colonoscopy to look for local cancer recurrence or new polyps or cancers a year after surgery.  If that exam is normal, another colonoscopy is called for three years later and then every five years. 

More Choices Increase Colorectal Cancer Screening Use

When people were offered a personal choice of either FOBT or colonoscopy screening by their primary care provider, more actually completed the test they chose than if only one option was offered. In a study of  1,000 ethnically and racially diverse people, the lowest percentage had a colonoscopy when that was the only test offered.  More completed fecal occult blood testing if it was the single choice. Overall 65 percent of the 1,000 patients studied were screened after their doctor recommended testing.

Nurses Endoscopists Can Perform Colonoscopy Safely and Effectively

Nurses and other health professionals may be necessary to meet demand for colonoscopies as colorectal cancer screening programs grow to meet needs.  Being sure that they can meet standards for quality exams is critical. In the Netherlands, five nurse endoscopists were trained to do colonoscopies under the supervision of a senior gastroenterologist. Each  had 100 consecutive procedures evaluated for both quality and patient satisfaction. During the study their exams met international standards for quality, and 95 percent of patients said that, overall, they were satisfied with their experience.

Annual Colonoscopy for Lynch Syndrome

Annual colonoscopies for people with Lynch syndrome (HNPCC or hereditary nonpolyposis colon cancer) successfully find cancers at an early stage. A recent study by the German HNPCC Consortium confirmed the effectiveness of annual colonoscopies to find colorectal cancers at a curable stage.  Regular colonoscopies found early cancers more often than did patient symptoms. Current recommendations are for surveillance colonoscopies to begin by age 25, be repeated every 1 to 2 years until age 40, and then annually.

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