CONTEXT: The necessary frequency of endoscopic colorectal cancer screening after a negative examination is uncertain. OBJECTIVE: To examine the yield of adenomas and cancer in the distal colon found by repeat flexible sigmoidoscopy (FSG) 3 years after a negative examination. DESIGN, SETTING, AND PARTICIPANTS: Participants were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), a randomized, controlled community-based study of cancer screening. The mean (SD) age was 65.7 (4.0) years at study entry (1993-1995) and 61.6% were men. Individuals underwent screening FSG at baseline and at 3 years as part of the protocol and were referred to their personal physicians for further evaluation of screen-detected abnormalities. Results from subsequent diagnostic evaluations were tracked in a standardized fashion. Of 11 583 eligible for repeat screening FSG 3 years after an initial negative examination, 9317 (80.4%) returned. MAIN OUTCOME MEASURES: Polyp or mass detection in distal colon at year 3 repeat FSG; incidence of adenoma or cancer in distal colon at year 3 examination; determination of reason for detection (increased depth of insertion or improved preparation at the year 3 examination or detection in a previously examined area). RESULTS:A total of 1292 returning participants (13.9%) had a polyp or mass detected by FSG 3 years after the initial examination. In the distal colon, 3.1% (292/9317) were found to have an adenoma or cancer. The incidence of advanced adenoma (n = 72) or cancer (n = 6) in the distal colon was 78 (0.8%) of 9317. Of individuals with advanced distal adenomas detected at the year 3 examination, 80.6% (58/72) had lesions found in a portion of the colon that had been adequately examined at the initial sigmoidoscopy. CONCLUSIONS: Repeat FSG 3 years after a negative examination will detect advanced adenomas and distal colon cancer. Although the overall percentage with detected abnormalities is modest, these data raise concern about the impact of a prolonged screening interval after a negative examination.
RCT Entities:
CONTEXT: The necessary frequency of endoscopic colorectal cancer screening after a negative examination is uncertain. OBJECTIVE: To examine the yield of adenomas and cancer in the distal colon found by repeat flexible sigmoidoscopy (FSG) 3 years after a negative examination. DESIGN, SETTING, AND PARTICIPANTS: Participants were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), a randomized, controlled community-based study of cancer screening. The mean (SD) age was 65.7 (4.0) years at study entry (1993-1995) and 61.6% were men. Individuals underwent screening FSG at baseline and at 3 years as part of the protocol and were referred to their personal physicians for further evaluation of screen-detected abnormalities. Results from subsequent diagnostic evaluations were tracked in a standardized fashion. Of 11 583 eligible for repeat screening FSG 3 years after an initial negative examination, 9317 (80.4%) returned. MAIN OUTCOME MEASURES: Polyp or mass detection in distal colon at year 3 repeat FSG; incidence of adenoma or cancer in distal colon at year 3 examination; determination of reason for detection (increased depth of insertion or improved preparation at the year 3 examination or detection in a previously examined area). RESULTS: A total of 1292 returning participants (13.9%) had a polyp or mass detected by FSG 3 years after the initial examination. In the distal colon, 3.1% (292/9317) were found to have an adenoma or cancer. The incidence of advanced adenoma (n = 72) or cancer (n = 6) in the distal colon was 78 (0.8%) of 9317. Of individuals with advanced distal adenomas detected at the year 3 examination, 80.6% (58/72) had lesions found in a portion of the colon that had been adequately examined at the initial sigmoidoscopy. CONCLUSIONS: Repeat FSG 3 years after a negative examination will detect advanced adenomas and distal colon cancer. Although the overall percentage with detected abnormalities is modest, these data raise concern about the impact of a prolonged screening interval after a negative examination.
Authors: Adeyinka O Laiyemo; Chyke Doubeni; Paul F Pinsky; V Paul Doria-Rose; Andrew K Sanderson; Robert Bresalier; Joel Weissfeld; Robert E Schoen; Pamela M Marcus; Philip C Prorok; Christine D Berg Journal: Cancer Epidemiol Date: 2011-11-22 Impact factor: 2.984
Authors: Joel L Weissfeld; Robert E Schoen; Paul F Pinsky; Robert S Bresalier; V Paul Doria-Rose; Adeyinka O Laiyemo; Timothy Church; Lance A Yokochi; Susan Yurgalevitch; Joshua Rathmell; Gerald L Andriole; Saundra Buys; E David Crawford; Mona Fouad; Claudine Isaacs; Lois Lamerato; Douglas Reding; Philip C Prorok; Christine D Berg Journal: J Natl Cancer Inst Date: 2012-01-31 Impact factor: 13.506
Authors: Christopher D Jensen; Chyke A Doubeni; Virginia P Quinn; Theodore R Levin; Ann G Zauber; Joanne E Schottinger; Amy R Marks; Wei K Zhao; Jeffrey K Lee; Nirupa R Ghai; Jennifer L Schneider; Bruce H Fireman; Charles P Quesenberry; Douglas A Corley Journal: Clin Gastroenterol Hepatol Date: 2014-10-25 Impact factor: 11.382