Several screening trials have shown an association between detection of early-stage colorectal cancer and a reduction in mortality from colorectal cancer. In the National Polyp Study, early detection and removal of adenomatous polyps reduced the risk of colon cancer. It was unclear, however, whether the cancers prevented by colonoscopic polypectomy in the cohort were those with the potential to progress to cancer and cause death.This study estimated the long-term effect of colonoscopic detection of adenomatous polyps and their removal on mortality from colorectal cancer. The study population included all patients referred for initial colonoscopy at 7 National Polyp Study (NPS) clinical centers between 1980 and 1990 who had adenomatous or only nonadenomatous polyps. The cause of death and the death rate among patients whose adenomatous polyps had been removed were determined using the National Death Index. The mortality rate for colorectal cancer in the cohort among patients who had adenomas removed was compared with the expected incidence-based mortality rate in the general population (estimated from the Surveillance Epidemiology and End Results Program) and with the mortality rate in an internal control group of patients with nonadenomatous polyps.
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