Colorectal Cancer Risk Reduction and Prevention
Research Area: Cancer Prevention
Sidney Winawer, M.D., Dr. Sc., helmed the first study to demonstrate conclusively that removing adenomas reduced the risk of colorectal cancer. He was principal investigator of the landmark, NCI-funded National Polyp Study (NPS), initiated in the late 1970s under the sponsorship of the major gastroenterology societies.
Dr. Winawer’s NPS leadership led to describing the developmental stages of colorectal cancer, defining familial high-risk groups, promotion of colorectal screening, and demonstrating long-term reduction in incidence and mortality of colorectal cancer by removal of adenomatous polyps. His contributions led to the concept of screening colonoscopy, introduced in 1997 by the U.S. GI Consortium Guidelines Committee.
The NPS originally was designed to assess surveillance of persons after adenoma removal. However, the study also provided important data on the natural history of adenomas and colorectal cancer. Although the adenoma-carcinoma sequence was widely accepted at the time, the recommendation was for annual colonoscopy post-polypectomy. The NPS showed this could be relaxed to every 3 years, or longer in some patients.
A 2012 front-page The New York Times story, “Report Affirms Lifesaving Role of Colonoscopy,” reported on the NPS 20-year follow-up results in the New England Journal of Medicine. NPS participants who had undergone colonoscopic polypectomy had about 50% lower mortality from colorectal cancer than the control population.
Dr. Winawer was a long-time chief of the Gastroenterology and Nutrition service and chairman of the Cancer Control and Prevention Program at Memorial Sloan Kettering. He co-chaired the International Digestive Cancer Alliance, launched at the Vatican with major world GI societies to increase awareness and prevention of digestive cancers. He has been president of the American College of Gastroenterology, co-founder of the Israel Cancer Research Fund, and a founder of the New York Society for Gastrointestinal Endoscopy.
To learn more about Dr. Winawer, read his 2019 profile in VideoGIE.