James M Richter1, Emily J Campbell2, Daniel C Chung2. 1. Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: jrichter@mgh.harvard.edu. 2. Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Abstract
BACKGROUND: As more patients are screened for colorectal cancer a small but significant number of interval cancers develop after colonoscopy for colorectal cancer screening. MATERIALS AND METHODS: We reviewed records of 75,314 adult patients who underwent colonoscopy for screening or diagnostic purposes between 1998 and 2006 inclusively, and identified 77 who developed interval cancers within the next 5 years. We reviewed their original endoscopic findings to determine the clinical and endoscopic factors that might predict a greater risk for future cancers. RESULTS: Patients aged ≥ 60 years had a higher risk of an interval neoplasm (P < .0001). Interval cancers were more common on the right side of the colon and in the hepatic flexure (both P < .0001). We did not observe an increased rate of interval cancers in patients with poor preparation (P = .799); however, examination completion rates did affect the rate of interval cancers (P = .016). CONCLUSION: Better identification of higher risk patients and assurance of follow-up examinations might increase the percentage of colon cancers discovered at an early stage. Special attention to careful examination of the right colon is key.
BACKGROUND: As more patients are screened for colorectal cancer a small but significant number of interval cancers develop after colonoscopy for colorectal cancer screening. MATERIALS AND METHODS: We reviewed records of 75,314 adult patients who underwent colonoscopy for screening or diagnostic purposes between 1998 and 2006 inclusively, and identified 77 who developed interval cancers within the next 5 years. We reviewed their original endoscopic findings to determine the clinical and endoscopic factors that might predict a greater risk for future cancers. RESULTS:Patients aged ≥ 60 years had a higher risk of an interval neoplasm (P < .0001). Interval cancers were more common on the right side of the colon and in the hepatic flexure (both P < .0001). We did not observe an increased rate of interval cancers in patients with poor preparation (P = .799); however, examination completion rates did affect the rate of interval cancers (P = .016). CONCLUSION: Better identification of higher risk patients and assurance of follow-up examinations might increase the percentage of colon cancers discovered at an early stage. Special attention to careful examination of the right colon is key.
Authors: Matthew Chin; William Karnes; M Mazen Jamal; John G Lee; Robert Lee; Jason Samarasena; Matthew L Bechtold; Douglas L Nguyen Journal: World J Gastroenterol Date: 2016-11-21 Impact factor: 5.742