Colonoscopy Test for Colon Cancer May Be More Effective
WebMD News Archive
Although there is no dispute that people over age 50 should be screened for
colon cancer, the medical community has been split over which methods are best.
In addition to barium enemas and colonoscopies, other recommended screening
tests for colon cancer include a fecal occult test, which can detect blood in
the stool, and sigmoidoscopy, which is less invasive than a colonoscopy.
The study by Winawer and his colleagues is the first to match one method
against the other to see which is better at detecting polyps. The researchers
performed both barium enemas and colonoscopies on more than 500 people, and
also reviewed the findings on more than 300 other people who had only
colonoscopies. All the patients previously had polyps. Colonoscopies found
three times as many smaller polyps and twice as many larger ones as barium
"With colonoscopy, the potential implication for saving lives is
exceptional," says Winawer, who maintains that the overall costs of all
screening techniques are about equal. "With the rising costs of cancer
care, screening is becoming cost-saving."
Several colon cancer experts tell WebMD the study findings are welcome
confirmation of how they already have been practicing.
"To my knowledge this is this the largest, if not the only, comparison
of these two [methods], and the results are impressive. Most people have
already been favoring colonoscopy to barium enema, and this adds credibility to
that behavior," says Neal Meropol, MD, who reviewed the study for WebMD.
Though the findings aren't surprising, he says, the data from earlier studies
were not definitive. Meropol is director of gastroenterology cancer programs at
Fox Chase Cancer Center in Philadelphia.
Meropol also sees a broader application to the findings, noting that the
various medical societies should revisit their recommendations about which
method is preferred for colon cancer screening and follow-up.
David A. Rothenberger, MD, said further study is needed before colonoscopy
becomes the gold standard for colon cancer screening, although he says it is
essential for patients who require follow-up.
"Increasingly, people are demanding the 'Katie Couric approach,' even as
a first-time screening test," says Rothenberger, a clinical professor and
chief of the Division of Colon and Rectal Surgery at the University of
Minnesota, and director of cancer programs there.