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This Week in NEJM: Feb 23, 2012

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In NEJM this week, researchers in the US and the Netherlands report a study on the effect of colonoscopy on long-term prevention of colorectal cancer deaths. The team analyzed data from 2,602 patients who were referred for colonoscopy between 1980 and 1990, and who were found to have polyps during their examinations, which were then removed. After a median follow-up time of 15.8 years, the team found that 12 patients in the study had died of colorectal cancer, compared to an estimated 25.4 expected deaths from colorectal cancer in the general population. This suggests a 53 percent reduction in mortality with colonoscopy, the team says. "These findings support the hypothesis that colonoscopic removal of adenomatous polyps prevents death from colorectal cancer," they add.

Also in NEJM this week, researchers in the US and Australia report on the survival of patients with BRAF V600-mutant advanced melanoma after treatment with vemurafenib. The team assigned 132 previously treated melanoma patients to receive vemurafenib — after a median follow-up of 12.9 months, the overall response rate was 53 percent, median duration of response was 6.7 months, and median progression-free survival time was 6.8 months, they found. Further, median overall survival was 15.9 months. "Vemurafenib induces clinical responses in more than half of patients with previously treated BRAF V600–mutant metastatic melanoma," the team writes.

Finally in NEJM this week, researchers in Spain test the efficacy of colonoscopy versus fecal immunochemical testing for colorectal cancer screening. The team compared one-time colonoscopy in 26,703 trial participants with FIT done every two years in 26,599 participants. They found that patients were more likely to participate in FIT than colonoscopy, and that both methods identified colorectal cancer in patients at similar rates. However, they add, "more adenomas were identified in the colonoscopy group" than in the FIT group.

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