Colorectal cancer prevention by an optimized colonoscopy protocol

METHODS: retrospective cohort study of an optimized colonoscopy protocol: 

• telephonic reinforcement of bowel preparation instructions; 
• active inspection for polyps throughout insertion and circumferential withdrawal; and 
• timely updating of the protocol and documentation to incorporate the latest guidelines. 

RESULTS: 17,312 patients underwent screening colonoscopies by 59 endoscopists in South Carolina, USA. Over 78,375 person-years of observation, the colorectal cancer mortality reduction was 89% (p < 0.001; four CRC deaths vs. 35.95 expected). 

CONCLUSION: Over 80% reduction in colorectal cancer incidence and mortality is achievable in routine practice by implementing key colonoscopy principles targeting near-complete polyp clearance.

Int J Cancer. 2014 Sep 20. doi: 10.1002/ijc.29228.