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. 2022 Sep;96(3):553-562.e3.
doi: 10.1016/j.gie.2022.04.1343. Epub 2022 May 7.

Longitudinal assessment of colonoscopy adverse events in the prospective Cooperative Studies Program no. 380 colorectal cancer screening and surveillance cohort

Elizabeth A Kobe  1 , Brian A Sullivan  2 , Xuejun Qin  3 , Thomas S Redding 4th  4 , Elizabeth R Hauser  3 , Ashton N Madison  4 , Cameron Miller  5 , Jimmy T Efird  6 , Ziad F Gellad  7 , David Weiss  8 , Kellie J Sims  4 , Christina D Williams  9 , David A Lieberman  10 , Dawn Provenzale  2
Affiliations

Longitudinal assessment of colonoscopy adverse events in the prospective Cooperative Studies Program no. 380 colorectal cancer screening and surveillance cohort

Elizabeth A Kobe et al. Gastrointest Endosc. 2022 Sep.

Abstract

Background and aims: Data are limited regarding colonoscopy risk during long-term, programmatic colorectal cancer screening and follow-up. We aimed to describe adverse events during follow-up in a colonoscopy screening program after the baseline examination and examine factors associated with increased risk.

Methods: Cooperative Studies Program no. 380 includes 3121 asymptomatic veterans aged 50 to 75 years who underwent screening colonoscopy between 1994 and 1997. Periprocedure adverse events requiring significant intervention were defined as major events (other events were minor) and were tracked during follow-up for at least 10 years. Multivariable odds ratios (ORs) were calculated for factors associated with risk of follow-up adverse events.

Results: Of 3727 follow-up examinations in 1983 participants, adverse events occurred in 105 examinations (2.8%) in 93 individuals, including 22 major and 87 minor events (examinations may have had >1 event). Incidence of major events (per 1000 examinations) remained relatively stable over time, with 6.1 events at examination 2, 4.8 at examination 3, and 7.2 at examination 4. Examinations with major events included 1 perforation, 3 GI bleeds requiring intervention, and 17 cardiopulmonary events. History of prior colonoscopic adverse events was associated with increased risk of events (major or minor) during follow-up (OR, 2.7; 95% confidence interval, 1.6-4.6).

Conclusions: Long-term programmatic screening and surveillance was safe, as major events were rare during follow-up. However, serious cardiopulmonary events were the most common major events. These results highlight the need for detailed assessments of comorbid conditions during routine clinical practice, which could help inform individual decisions regarding the utility of ongoing colonoscopy follow-up.

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Conflict of interest statement

Conflict of interest statement:

BAS reports support from Exact Sciences, which is unrelated to the submitted work. No other authors have any potential conflicts to disclose.

Figures

Figure 1:
Figure 1:. Descriptive Cohort Diagram for Included Cooperative Studies Program no. 380 Participants with Baseline Examinations and Follow-up Examinations
*699 total examinations in 423 participants #Total number is not equal to major + minor major adverse events because some individuals had both major and minor adverse events occur on the same examination
See this image and copyright information in PMC

Comment in

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