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To the Editor: In their study of the risk of colorectal cancer (CRC), Dr Singh and colleagues¹ conclude that in persons who undergo a colonoscopy during which no neoplastic lesions are identified, "the risk of developing CRC is at most 60% to 70% of the risk of developing CRC in the general population," although the size of risk reduction "may not be as great as previously suspected."

We believe that for at least the first several years after a negative screening colonoscopy, there is actually a greater risk reduction than was estimated in this study. Singh et al acknowledged that their sources of data provided no information about the reason the colonoscopy had been performed. They excluded from the cohort persons who had a history of prior colorectal endoscopy or surgery or inflammatory bowel disease. However, an unknown but possibly large proportion of colonoscopic examinations would have been in response . . . [Full Text of this Article]

Noel S. Weiss, MD, DrPH
nweiss@u.washington.edu
Department of Epidemiology
University of Washington

V. Paul Doria-Rose, DVM, PhD
Fred Hutchinson Cancer Research Center
Seattle

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