"Is Colonoscopy Necessary" is an interesting example of a paper on the gastrointestinal system. A colonoscopy is a test done by a doctor or a nurse in your large intestines or bowels. It is usually performed by a colon scope which is passed into the patient’ s anus up to the colon. At times it can be passed up to the caecum, where the large and small intestines meet. The doctor or a nurse may perform a colonoscopy on a patient who has abdominal pains, bleeding anus, or constant diarrhea. Cancer has for some years now been the highest killing disease as shown by research.
Breast cancer has the highest numbers so far. Most incidence of colorectal cancer has been reported in Europe and Ireland being a country in the continent has been used as an example in the study. In the year 2006, a report by the European society for medical oncology showed that colorectal cancer had affected 12.9 %( Ann Oncol pg 18) of the European population. Ireland being among the countries in Europe had the highest numbers of people with colorectal cancer: had 34.9% reported cases of both sexes (male and female).
While the men had the highest percentage of 43% and women 27.1%. Therefore the report by research that shows Europe had the highest incidence and prevalence of colorectal cancer is really factual. The government of Ireland following the alarming numbers of people suffering from colorectal cancer, through the Ministry of Health and Children, established the National Screening service in January 2007. This was after the launch of the Strategy for Cancer Control in Ireland in 2006. The strategy was to emphasize the prevention, screening, detection and treatment, and future management of any type of cancer.
Many sub-boards to oversee cancer-related complications were also formed and one specifically for colorectal cancer was the National Bowel Screening Programme. International studies and research show that colonoscopy should be avoided with acute diverticulitis reason being it risks perforation. If it is a must that coloscopy should be performed, then 6-8 weeks when the inflation subsides. Currently accepted society and international guidelines recommend routine colonoscopic evaluation after one episode of acute diverticulitis. The results of the study are similar to international studies done.
They both come into the conclusion that if diverticulitis is not complicated then a routine coloscopy is not necessary. Screening colonoscopies are useless in the New England Journal of Medicine found out that patients in the studies had at least adenoma detected on colonoscopy but did not have cancer but developed cancer in later years. Computed colonography is highly sensitive for colorectal cancer, especially when both cathartic and tagging agents are combined in the bowel preparation. Given the low prevalence of colorectal cancer. Primary computed colonography is more suitable for the initial investigation of suspected colorectal cancer. Forty-nine studies provided data on 11,151 patients with cumulative colorectal cancer, of 3.6% (414 cancers).
The sensitivity of computed colonography for colorectal cancer 96.1% 398 of 414; 95% was detected. No cancers were missed when both cathartic and tagging agents were combined in the bowel preparation. Therefore crediting the computing colonography to be more reliable, more sensitive, and specific too. A noticeable limitation of the study is that there was the unavailability of data from private and interstate hospitals and also a low prevalence of cancer.
Therefore reducing the statistical power of the study. The recommendation by the study that after CT-proven uncomplicated diverticulitis seems to be unnecessary but colonoscopy should be performed with a diagnosis of a diverticular abscess. A national screening program whose aim is to prevent colorectal cancer instead should be adopted. It will help in the awareness and treatment of the affected patients and also help in managing colorectal cancer in the near future.
BRITISH JOURNAL OF SURGERY VOLUME 98,ISSUE 11 PAGES 1630-1634,NOVEMBER 2011
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