Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death

Post by thaumasiotes » Mon, Oct 10, 2022, 8:55 AM UTC

sokoloff wrote: post #35

em500 wrote: post #32

Earlier quoted context omitted.

Yup. The study answers a question from health policy makers: Should we invite everyone (in some age group) for a colonoscopy? Based on this study, probably not. It does not answer questions from individuals: Should I get a colonoscopy? If you have some good reason (symptoms, doctor advice, family history), probably yes (based on other studies, not this one).

To the extent that there’s a spread in those answers, a third possibility emerges: how can we, as health policy makers, find a way to make the invitations more effective at converting to administered colonoscopies?

Post by ricardobeat » Mon, Oct 10, 2022, 8:59 AM UTC

hef19898 wrote: post #34

jvanderbot wrote: post #31

Earlier quoted context omitted.

Well, to be fair, the overall risk of death did not seem to be lower for the invited group. The risk was 11.04 vs 11.03 for those with invited colonoscopy, with fairly large confidence interval on the control group. But the risk of colon cancer did decrease, with a risk reduction of 18%. Maybe they just didn't track long enough to tease out a bigger risk reduction in overall mortality, or maybe colon cancer is associ…

Invited or not, if you don't show up to a colonoscopy you don't get one. Which means the study's data on invitations alone cannot be used to evaluate the effect of colonoscopies. Seems the study does provide data that allows this so, and shows clear differences in cancer rates and survival rates for those that did get colonoscopies. Argueing about the randomization of these numbers, and the meta-statistical aspects o…

Post by sokoloff » Mon, Oct 10, 2022, 9:01 AM UTC

thaumasiotes wrote: post #41

sokoloff wrote: post #35

Earlier quoted context omitted.

To the extent that there’s a spread in those answers, a third possibility emerges: how can we, as health policy makers, find a way to make the invitations more effective at converting to administered colonoscopies?

Why would that be a goal? First you'd need to show that colonoscopies were helpful in general, or that invitations were going to a subpopulation in which colonoscopies were helpful.

Post by hef19898 » Mon, Oct 10, 2022, 9:08 AM UTC

kgwgk wrote: post #46

hef19898 wrote: post #40

Earlier quoted context omitted.

I am not doing this, I'm saying the study cannot be used to say colonoscopies don't help.

It cannot be used to say that the help either, but you wrote “Seems the study does provide data that allows this so, and shows clear differences in cancer rates and survival rates for those that did get colonoscopies.”

Post by em500 » Mon, Oct 10, 2022, 9:13 AM UTC

ricardobeat wrote: post #29

em500 wrote: post #27

Several posters have criticized the title of the news article "In gold-standard trial, colonoscopy fails to reduce rate of cancer deaths". The actual study is titled "Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death" [1] The authors conclude that "In this randomized trial, the risk of colorectal cancer at 10 years was lower among participants who were invited to undergo screening colono…

There is nothing wrong with the title. The study failed to find a reduction in death rate despite lowering the incidence of cancer, and that is the center of the piece. It goes into detail of why this is surprising. The study authors were interviewed and agreed. The reporting actually adds a lot of context that you would never get from a link to a random study. Like, for example, how it is called the “gold standard”…