articulo cientifico
Páginas: 5 (1056 palabras)
Publicado: 29 de enero de 2015
Intoduccion.
A continuacion se prsentara un artículo cientifico elaborado por la revista The New England Journal Of Medicine., y se presentara su traducción al español, dicho reporte medico habla sobre la mortalidad del cancer, las consecuenacias después de algunos metodos utilizados y puestos a aprueba, asi como tambien se demuestran los efectos sobre algunos metodos paraconbatir y/o experimentar nuevas soluciones contra el mismo.
-Al final de dicho articulo y traducción se mostrara la bibliografia, y procedencia de dicha información.
Long-Term Colorectal-Cancer Mortality after Adenoma Removal
N Engl J Med 2014; 371:2035-2037November 20, 2014DOI: 10.1056/NEJMc1411954
Article
To the Editor:
The study ofcolorectal-cancer mortality by Løberg et al. (Aug. 28 issue) provides no data on the quality of the colonoscopies performed. This limitation outweighs the merits of the large population size and prolonged follow-up in this study, and it precludes meaningful inferences regarding the protective effect of colonoscopy against colorectal cancer.
We think the results are best explained by polyps leftbehind or incompletely removed because of the use of a suboptimal technique.
The timing of colonoscopy may explain the modest mortality benefit among patients with low-risk adenomas versus no benefit among patients with multiple polyps, since younger patients have fewer and less advanced polyps. Our recent study involving patients who received treatment from an endoscopy group with anextraordinary, continuous, and prolonged focus on optimal mucosal inspection and complete polypectomy, as compared with the general population, showed an 83% reduction in the incidence of colorectal cancer and an 89% reduction in mortality.4 The incidence of lung cancer in our study population was identical to that of the general population; this validated the substantial protective effect of high-qualitycolonoscopy against colorectal cancer. In our opinion, details about the quality of colonoscopy are more important than population size or follow-up in studies of methods to lower colorectal-cancer mortality.
Løberg et al. state that their study “extends recent findings from the National Polyp Study. We confirm that the risk of death from colorectal cancer after adenoma removal is similar to therisk of death from colorectal cancer in the general population.” However, the National Polyp Study reported a 53% reduction in long-term mortality after colonoscopic polypectomy,1 and it required complete high-quality colonoscopy and complete removal of all identified polyps at baseline. Almost complete eradication of high-risk adenomas (97%) was documented at surveillance.2 It would beinformative if Løberg and colleagues could also link mortality data to data on the performance of colonoscopy and polypectomy. Their observations provide support for the recommendation of conservative surveillance in patients with low-risk adenomas.3 Surveillance in patients with high-risk adenomas is more compelling, considering the increased colorectal-cancer mortality among these patients4 and themarked reduction in mortality observed in the National Polyp Study, which involved a cohort in which 55% of the patients had high-risk adenomas.1,2 However, the contribution of high-quality baseline colonoscopy and polypectomy, as compared with surveillance, in these results is unclear.
Sidney J. Winawer, M.D. Memorial Sloan Kettering Cancer Center, New York, NY La Mortalidad a Largo Plazo Colorrectal-Cáncer después de la Extirpación del Adenoma
N Engl J Med 2014; 371: 2035-2037November 20, 2014DOI: 10.1056 / NEJMc1411954
Artículo
Sr. Editor:
El estudio de la mortalidad del cáncer colorrectal-por Løberg et al. (28 de agosto de emisión) no proporciona datos sobre la calidad de las colonoscopias realizadas. Esta limitación es...
Intoduccion.
A continuacion se prsentara un artículo cientifico elaborado por la revista The New England Journal Of Medicine., y se presentara su traducción al español, dicho reporte medico habla sobre la mortalidad del cancer, las consecuenacias después de algunos metodos utilizados y puestos a aprueba, asi como tambien se demuestran los efectos sobre algunos metodos paraconbatir y/o experimentar nuevas soluciones contra el mismo.
-Al final de dicho articulo y traducción se mostrara la bibliografia, y procedencia de dicha información.
Long-Term Colorectal-Cancer Mortality after Adenoma Removal
N Engl J Med 2014; 371:2035-2037November 20, 2014DOI: 10.1056/NEJMc1411954
Article
To the Editor:
The study ofcolorectal-cancer mortality by Løberg et al. (Aug. 28 issue) provides no data on the quality of the colonoscopies performed. This limitation outweighs the merits of the large population size and prolonged follow-up in this study, and it precludes meaningful inferences regarding the protective effect of colonoscopy against colorectal cancer.
We think the results are best explained by polyps leftbehind or incompletely removed because of the use of a suboptimal technique.
The timing of colonoscopy may explain the modest mortality benefit among patients with low-risk adenomas versus no benefit among patients with multiple polyps, since younger patients have fewer and less advanced polyps. Our recent study involving patients who received treatment from an endoscopy group with anextraordinary, continuous, and prolonged focus on optimal mucosal inspection and complete polypectomy, as compared with the general population, showed an 83% reduction in the incidence of colorectal cancer and an 89% reduction in mortality.4 The incidence of lung cancer in our study population was identical to that of the general population; this validated the substantial protective effect of high-qualitycolonoscopy against colorectal cancer. In our opinion, details about the quality of colonoscopy are more important than population size or follow-up in studies of methods to lower colorectal-cancer mortality.
Løberg et al. state that their study “extends recent findings from the National Polyp Study. We confirm that the risk of death from colorectal cancer after adenoma removal is similar to therisk of death from colorectal cancer in the general population.” However, the National Polyp Study reported a 53% reduction in long-term mortality after colonoscopic polypectomy,1 and it required complete high-quality colonoscopy and complete removal of all identified polyps at baseline. Almost complete eradication of high-risk adenomas (97%) was documented at surveillance.2 It would beinformative if Løberg and colleagues could also link mortality data to data on the performance of colonoscopy and polypectomy. Their observations provide support for the recommendation of conservative surveillance in patients with low-risk adenomas.3 Surveillance in patients with high-risk adenomas is more compelling, considering the increased colorectal-cancer mortality among these patients4 and themarked reduction in mortality observed in the National Polyp Study, which involved a cohort in which 55% of the patients had high-risk adenomas.1,2 However, the contribution of high-quality baseline colonoscopy and polypectomy, as compared with surveillance, in these results is unclear.
Sidney J. Winawer, M.D. Memorial Sloan Kettering Cancer Center, New York, NY La Mortalidad a Largo Plazo Colorrectal-Cáncer después de la Extirpación del Adenoma
N Engl J Med 2014; 371: 2035-2037November 20, 2014DOI: 10.1056 / NEJMc1411954
Artículo
Sr. Editor:
El estudio de la mortalidad del cáncer colorrectal-por Løberg et al. (28 de agosto de emisión) no proporciona datos sobre la calidad de las colonoscopias realizadas. Esta limitación es...
Leer documento completo
Regístrate para leer el documento completo.