Core IM | Internal Medicine Podcast #154 Does Invitation To Screening Colonoscopy Save lives? Beyond Journal Club with NEJM Group on the NordICC Trial
Jun 19, 2024
Exploring the impact of colonoscopy on preventing colon cancer, analyzing NordICC trial, the complexities in studying colon cancer screening benefits, debate over analysis methods, comparison of colonoscopy and sigmoidoscopy, controversy in screening colonoscopy, and importance of advising patients on lifestyle modifications.
AI Snips
Chapters
Transcript
Episode notes
Colorectal Cancer Progression Timeline
- Colorectal cancer usually progresses from adenoma to carcinoma over years. - It can take up to two decades for a small adenoma to become cancerous, making screening benefits slow to observe.
Low Incidence Challenges Trials
- Only about 4% of people develop colorectal cancer in their lifetime. - This low incidence complicates trials by requiring large numbers to show mortality benefits of screening.
Choosing Screening Outcome Metrics
- Choosing the right outcome measure in cancer screening is complex: all-cause mortality, cancer-specific mortality, or cancer incidence. - Each has advantages and limitations; cancer-specific mortality may better reflect screening impact.