Wendy Atkin

Which leads us to the question which comes up periodically, is a once-in-a-lifetime colonoscopy enough? And then after 10, 15 years, we add something which, because people are very old, detects only cancer?

Well, there were those studies which made a lot of impact at the time and have been usually forgotten by Wendy Atkin and her group that, I think it was in Lancet probably 10 or 12 years ago, that showed if you had a... normal colonoscopy, I forget when it was in that study, and you either had no polyps or a modestly sized one, your lifetime risk following that was lower than the general population, and that stands to reason.

You've identified at time zero people who make lots of or big polyps, and you've identified people who don't, and there probably is something systematically different about the two.

So yeah, I think you could make an argument that one colonoscopy, particularly in a resource-constrained area, makes good sense.