Interval post-colonoscopy colorectal cancer following a negative colonoscopy in a fecal immunochemical test-based screening program.
Endoscopy
; 55(12): 1061-1069, 2023 Dec.
Article
in En
| MEDLINE
| ID: mdl-37793423
ABSTRACT
BACKGROUND:
In the Dutch colorectal (CRC) screening program, fecal immunochemical test (FIT)-positive individuals are referred for colonoscopy. If no relevant findings are detected at colonoscopy, individuals are reinvited for FIT screening after 10 years. We aimed to assess CRC risk after a negative colonoscopy in FIT-positive individuals.METHODS:
In this cross-sectional cohort study, data were extracted from the Dutch national screening information system. Participants with a positive FIT followed by a negative colonoscopy between 2014 and 2018 were included. A negative colonoscopy was defined as a colonoscopy during which no more than one nonvillous, nonproximal adenoma <â10âmm or serrated polyp <â10âmm was found. The main outcome was interval post-colonoscopy CRC (iPCCRC) risk. iPCCRC risk was reviewed against the risk of interval CRC after a negative FIT (FIT IC) with a 2-year screening interval.RESULTS:
35â 052 FIT-positive participants had a negative colonoscopy and 24 iPCCRCs were diagnosed, resulting in an iPCCRC risk of 6.85 (95â%CI 4.60-10.19) per 10â 000 individuals after a median follow-up of 1.4 years. After 2.5 years of follow-up, age-adjusted iPCCRC risk was approximately equal to FIT IC risk at 2 years.CONCLUSION:
Risk of iPCCRC within a FIT-based CRC screening program was low during the first years after colonos-copy but, after 2.5 years, was the same as the risk in FIT-negative individuals at 2 years, when they are reinvited for screening. Colonoscopy quality may therefore require further improvement and FIT screening interval may need to be reduced after negative colonoscopy.
Full text:
1
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
/
Adenoma
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Child, preschool
/
Humans
Language:
En
Journal:
Endoscopy
Year:
2023
Type:
Article
Affiliation country:
Netherlands