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.
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.
Authors: Michal F Kaminski; Paulina Wieszczy; Maciej Rupinski; Urszula Wojciechowska; Joanna Didkowska; Ewa Kraszewska; Jaroslaw Kobiela; Robert Franczyk; Maria Rupinska; Bartlomiej Kocot; Anna Chaber-Ciopinska; Jacek Pachlewski; Marcin Polkowski; Jaroslaw Regula Journal: Gastroenterology Date: 2017-04-17 Impact factor: 22.682
Authors: Chantal M C le Clercq; Mariëlle W E Bouwens; Eveline J A Rondagh; C Minke Bakker; Eric T P Keulen; Rogier J de Ridder; Bjorn Winkens; Ad A M Masclee; Silvia Sanduleanu Journal: Gut Date: 2013-06-06 Impact factor: 23.059
Authors: Michael Goodman; Robert H Fletcher; V Paul Doria-Rose; Christopher D Jensen; Alexis M Zebrowski; Tracy A Becerra; Virginia P Quinn; Ann G Zauber; Douglas A Corley; Chyke A Doubeni Journal: J Comp Eff Res Date: 2015-07-23 Impact factor: 1.744
Authors: Jeffrey K Lee; Christopher D Jensen; Alexander Lee; Chyke A Doubeni; Ann G Zauber; Theodore R Levin; Wei K Zhao; Douglas A Corley Journal: Gastrointest Endosc Date: 2015-01-08 Impact factor: 9.427
Authors: David I Fudman; Amit G Singal; Mark G Cooper; MinJae Lee; Caitlin C Murphy Journal: Clin Gastroenterol Hepatol Date: 2021-11-26 Impact factor: 13.576
Authors: Nicholas E Burr; Edmund Derbyshire; John Taylor; Simon Whalley; Venkataraman Subramanian; Paul J Finan; Matthew D Rutter; Roland Valori; Eva J A Morris Journal: BMJ Date: 2019-11-13