Doctors Who Take More Time With Colonoscopy Find More Tumours

December 15, 2006 – 1:22 am | posted in Cancer / Oncology, Colorectal Cancer, Medical Devices, Seniors / Aging

A new US study suggests that doctors who take more time (more than 6 minutes) to look for cancerous and pre-cancerous tumours in the bowel using colonoscopy tend to be better at detection than those who take less time.

The study is published in the New England Journal of Medicine.

The research team, led by Dr. Robert L. Barclay of Rockford Gastroenterology Associates, compared rates of detection of colorectal adenomas (polyps or abnormal growths in the bowel or digestive tract) against the time doctors spent searching for them. They looked at data from nearly 8,000 colonoscopies performed by 12 experienced gastroenterologists over a 15-month period in a community-based practice.

The researchers found large variations in the detection rates among the doctors, who overall detected tissue growths (neoplasia) in 23.5% of the patients. They also found that the time the doctors spent on searching for growths varied from 3.1 to 16.8 minutes for examinations where no polyps were removed.

The results indicated that those procedures that lasted an average of 6 minutes or less tended to detect fewer polyps, both cancerous and pre-cancerous, than those that took more time.

The researchers are cautious about generalising from these results since they come from a small study on 12 doctors in one practice. However, they suggest that doctors who perform colonscopies in order to find and remove polyps should perhaps spend a little more time on the procedure as this is likely to lead to more effective early detection of tumours.

Colonoscopy is a non-surgical examination performed under anasthetic where a fibre optic camera is inserted in the patient’s anus and pushed up into the bowel. With this procedure doctors can see any abnormal growths and ulcers, remove small polyps and tissue samples and look at them under a microscope (biopsy) to check for signs of cancer.

Risks of serious complication from colonoscopies are extremely low (less than 0.5 per cent), which compared with the high rate of deaths from bowel cancer in the over 50s, makes this an effective screening test.

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