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. 2019 Jan;89(1):168-176.e3.
doi: 10.1016/j.gie.2018.08.023. Epub 2018 Aug 23.

Index colonoscopy-related risk factors for postcolonoscopy colorectal cancers

Theodore A Tollivoro  1 , Christopher D Jensen  1 , Amy R Marks  1 , Wei K Zhao  1 , Joanne E Schottinger  2 , Virginia P Quinn  2 , Nirupa R Ghai  2 , Ann G Zauber  3 , Chyke A Doubeni  4 , Theodore R Levin  1 , Bruce Fireman  1 , Charles P Quesenberry  1 , Douglas A Corley  1
Affiliations

Index colonoscopy-related risk factors for postcolonoscopy colorectal cancers

Theodore A Tollivoro et al. Gastrointest Endosc. 2019 Jan.

Abstract

Background and aims: Postcolonoscopy colorectal cancers (PCCRCs) are defined as those detected ≤10 years after an index colonoscopy negative for cancer, but modifiable risk factors are not well established in large, community-based populations.

Methods: We evaluated risk factors from the index colonoscopy for PCCRCs diagnosed 1 to 10 years after an index colonoscopy using a case-control design. Odds ratios (OR) and 95% confidence intervals (CI) were adjusted for potential confounders.

Results: A proximal polyp ≥10 mm (OR, 8.18; 95% CI, 4.59-14.60), distal polyp ≥10 mm (OR, 3.30; 95% CI, 1.65-6.58), adenoma with (OR, 3.23; 95% CI, 1.83-5.68) and without advanced histology (OR, 1.87; 95% CI, 1.37-2.55), and an incomplete colonoscopy (OR, 5.52; 95% CI, 2.98-10.21) were associated with PCCRC. Risk factors for early versus late cancers (12-36 months vs >36 months to 10 years after examination) included incomplete polyp excision in the colonic segment of the subsequent cancer (OR, 4.76; 95% CI, 2.35-9.65); failure to examine the segment (OR, 2.42; 95% CI, 1.27-4.60); and a polyp ≥10 mm in the segment (OR, 2.38; 95% CI, 1.53-3.70). A total of 559 of 1206 patients with PCCRC (46.4%) had 1 or more risk factors that were significant for PCCRC (incomplete examination, large polyp, or any adenoma).

Conclusions: In a large community-based study with comprehensive capture of PCCRCs, almost half of PCCRCs had potentially modifiable factors related to polyp surveillance or removal and examination completeness. These represent potential high-yield targets to further increase the effectiveness of colorectal cancer screening.

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Conflict of interest statement

Disclosures: No conflicts of interest exist for any of the authors.

References

    1. Colorectal Cancer Statistics. http://www.cdc.gov/cancer/colorectal/statistics/index.htm. Accessed 3/29/16.
    1. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149(9):627–637. - PubMed
    1. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(23):2564–2575. - PubMed
    1. le Clercq CM, Sanduleanu S. Interval colorectal cancers: what and why. Curr Gastroenterol Rep. 2014;16(3):375. - PubMed
    1. Sanduleanu S, le Clercq CM, Dekker E, et al. Definition and taxonomy of interval colorectal cancers: a proposal for standardising nomenclature. Gut. 2015;64(8):1257–1267. - PubMed

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