Article Review
Brenner, H., Chang-Claude, J., Seller, C. M., Rickert, A., & Hoffmeister, M. (2011). Protection From Colorectal Cancer After Colonoscopy: A Population-Based, Case-Control Study. Ann Intern Med, 22-30.
Introduction
The article, Protection from Colorectal Cancer after Colonoscopy, by Herman Brenner, Jenny Chang-Claude, Christoph M. Seller, Alexander Rickert and Michael Hoff Meister, seeks to define the relation between risk of Colorectal Cancer and previous colonoscopy. Colorectal Cancer, CRC, is common in both men and women; it is common in women than men. There are more than 1 million cases of CRC worldwide, and it claims more than 500,000 deaths annually (Brenner, Chang-Claude, Seller, Rickert, & Hoffmeister, 2011). Colonoscopy is the treatment method for CRC because it helps physicians to detect it in the early stages. A study conducted by the National Polyp showed a reduction of 76% to 90% of CRC in patients through colonoscopy. The researchers sought to verify the National Poly’s study on the differences between CRC in the left and right colon. The variable for their study was an area with high cases of CRC in older people. Using their assessment, the researchers settled for Rhine-Neckar region, Germany.
The study featured 1688 CRC case patients and 1932 patients above the age of 50 as control patients. The assessment of patients began in January 2003 and ended in June 2004. Due to the study’s nature, the researchers had to use historical data to narrow down on the patients required to conduct the research. The researchers measured the odd ratios of CRC in a span of ten years and sought those related to colonoscopy (Brenner, Chang-Claude, Seller, Rickert, & Hoffmeister, 2011). They sorted the data by sex, educational level, family history, body mass index, hormone replacement therapy, general health screening, and smoking status. For data analysis, the researchers ignored the data collected for patients who were less than 50 years. The remaining data had to undergo several screenings for inflammatory bowel disease, missing information of colonoscopy treatment or miscalculations and mode of detection. They used medical records for clarification purposes where applicable. They noted 91 percent of colonoscopies in the cecum and 26 percent of it in polyps. The researchers derived relative risk estimates as a way of evaluating potential variation in reducing the population of groups.
Results
Discussion
Protection of CRC comes from the removal of adenomas during the colonoscopy treatment though it may not be protective to itself. Since most cases of CRC are present in advanced stages of adenomas, it is quite easy to detect and remove it completely from the system (Brenner, Chang-Claude, Seller, Rickert, & Hoffmeister, 2011). The CRC risk reduction after colonoscopy from one to ten years was larger than the reduction of advanced neoplasm present in recent studies done in Germany. Prevalence dropped to 48 percent on the rectum and left colon while 67 percent drop was present in the right colon.
Conclusion
Despite the limitations of the study, removal of colorectal adenomas and colonoscopy helps in treating CRC incidences. It is much easier and faster to reduce CRC present on the right side, unlike the left side. It is achievable in the community setting, where people pair the widespread of colonoscopy to its quality assurance and training. Apart from treatment, colonoscopy provides a 50 percent risk reduction of CRC in cancer found on the right side of the colon.
Frei, P., Poulsen, A. H., Johansen, C., Olsen, J. H., Steding-Jessen, M., & Schuz, J. (2011). Use of Mobile Phones and Risk of Brain Tumours: Update of Danish Cohort Study. BMJ.
Introduction
Mobile phones are important devices to human beings as they assist in communication and other common activities such as setting reminders for meetings, writing down notes or to-do lists among other things. Hence, its usage increased over the years at a significant rate. However, its technology continues to cause harm to the users, but few have the knowledge about it. Hence, the second article focuses on the risk of brain tumors due to extensive use of mobile phones. Its authors continue to examine the changes in technology and its effect on the users on an annual basis (Frei, et al., 2011). The setting is in Denmark, Switzerland and focuses on Danes above the aged 30 years and born after 1925. It includes mobile subscribers and non-subscribers before 1995.
The study’s main design incorporates the nationwide cohort study that reveals the information of users and their health developments. The researchers use the complete Danish Cancer Register to identify brain tumor risks discovered since the introduction of mobile phones. They classify the results by sex, calendar period, age, calendar period, and disposable income to determine the various situations and results. The analysis factored in the number of people recorded with brain tumors as from 1990 who were at the age of 30 until the first date of cancer diagnosis. The classifications excluded 3117 subscribers from the study because they had cancer before their mobile phone usage (Frei, et al., 2011). Another 370 participants showed signs of cancer before the end of their first of subscription. The final number of those assessed stood at 358,403 people. For analysis, the researchers used the linear Poisson regression models to map out the estimate incidence ratios of cancer diagnosis after exposure to mobile phones for a year. Next, the researchers classified the information by sex and grouped them into five-year age groups, that is, 30 to 34, 35 to 40, etc. The major limitation was reliance on recorded information, which might be biased. There was no physical interaction with the participants.
Results
Between the year 1990 and 2007, there were 10,729 subscribers with cases of tumors. During the same period, the subscriber numbers increased from 358,403 to 3.8 million people (Frei, et al., 2011). The risk of tumors was equal in both male and female. Subscribers with the longer usage of mobile phones, 13 years and above, the ratio of incidence rate stood at 1.03 with a 95 percent confidence interval of 0.83 and 1.27 in men while women stood at 0.91 with a 95 percent confidence interval of 0.41 and 2.04. Those with less than subscriptions of ten years, their ratio of incidence rate stood at 1.04 with a 95 percent confidence interval of 0.85 and 1.26 in men while women stood at 1.04 with a 95 percent confidence interval of 0.56 and 1.95. However, the researchers did not indicate any dose-response when relation to the years after the first subscription or the tumor’s anatomical tumor.
Conclusion
The researchers found no increase in tumor risks to the central nervous system and the nationwide cohort study provided little evidence towards the casual association. The extended follow-up enabled the researchers to investigate mobile phone effects on the people who used them for more than ten years and found that it did not lead to higher risk of cancer. Similarly, the risks of temporal glioma were not present in the study, and the tumor’s location was independent of the use of mobile phones. However, it was quite hard for the researchers to conduct a thorough study due to the limitations of personal observation. Their report was purely from the National cohort study.
References
Brenner, H., Chang-Claude, J., Seller, C. M., Rickert, A., & Hoffmeister, M. (2011). Protection From Colorectal Cancer After Colonoscopy: A Population-Based, Case-Control Study. Ann Intern Med, 22-30.
Frei, P., Poulsen, A. H., Johansen, C., Olsen, J. H., Steding-Jessen, M., & Schuz, J. (2011). Use of Mobile Phones and Risk of Brain Tumours: Update of Danish Cohort Study. BMJ.
