Long-Term Colorectal Cancer Incidence and Mortality After a Single Negative Screening Colonoscopy

Pilonis, Nastazja D.; Bugajski, Marek; Wieszczy, Paulina; Franczyk, Robert; Didkowska, Joanna; Wojciechowska, Urszula; Pisera, Malgorzata; Rupiński, Maciej; Reguła, Jarosław; Kaminski, Michal F.

doi:10.7326/m19-2477

Cited by 78 publications

(67 citation statements)

References 36 publications

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“…These findings are in line with previous studies questioning the need for surveillance after 10 or 15 years. 22,23 By reallocating resources to individuals with the highest risk, we believe that the total amount of surveillance colonoscopies can be reduced dramatically without patient harm. The observed trends were consistent with different ADR cutoffs, and different follow-up times after screening and could be reproduced in an independent screening colonoscopy cohort from Austria including 137,169 colonoscopies, although with a shorter follow-up and thus fewer events.…”

Section: Discussionmentioning

confidence: 99%

Colonoscopist Performance and Colorectal Cancer Risk After Adenoma Removal to Stratify Surveillance: Two Nationwide Observational Studies

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Colonoscopist Performance and Colorectal Cancer Risk After Adenoma Removal to Stratify Surveillance: Two Nationwide Observational Studies

et al. 2021

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“…Although this study also showed a relative risk reduction for CRC beyond 12 years from colonoscopy, absolute CRC incidence reached the same threshold as for average risk individuals aged 50 to 54, 7 years postnegative colonoscopy ( 20 ). Conversely, a recent report from Poland showed reductions in incidence/mortality for up to 17 years among those with a negative screening colonoscopy compared with the general population ( 21 ). Although encouraging, these observations were in a population with a much greater CRC incidence and lower screening colonoscopy rate than the United States.…”

Section: Introductionmentioning

confidence: 99%

Detection of Postcolonoscopy Colorectal Neoplasia by Multi-target Stool DNA

Ebner

Eckmann

Burger

et al. 2021

Clin Transl Gastroenterol

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INTRODUCTION: Significant variability between colonoscopy operators contributes to postcolonoscopy colorectal cancers (CRCs). We aimed to estimate postcolonoscopy colorectal neoplasia (CRN) detection by multi-target stool DNA (mt-sDNA), which has not previously been studied for this purpose. METHODS: In a retrospective cohort of patients with +mt-sDNA and completed follow-up colonoscopy, positive predictive value (PPV) for endpoints of any CRN, advanced adenoma, right-sided neoplasia, sessile serrated polyps (SSP), and CRC were stratified by the time since previous colonoscopy (0–9, 10, and ≥11 years). mt-sDNA PPV at ≤9 years from previous average-risk screening colonoscopy was used to estimate CRN missed at previous screening colonoscopy. RESULTS: Among the 850 studied patients with +mt-sDNA after a previous negative screening colonoscopy, any CRN was found in 535 (PPV 63%). Among 107 average-risk patients having +mt-sDNA ≤9 years after last negative colonoscopy, any CRN was found in 67 (PPV 63%), advanced neoplasia in 16 (PPV 15%), right-sided CRN in 48 (PPV 46%), and SSP in 20 (PPV 19%). These rates were similar to those in 47 additional average risk persons with previous incomplete colonoscopy and in an additional 68 persons at increased CRC risk. One CRC (stage I) was found in an average risk patient who was mt-sDNA positive 6 years after negative screening colonoscopy. DISCUSSION: The high PPV of mt-sDNA 0–9 years after a negative screening colonoscopy suggests that lesions were likely missed on previous examination or may have arisen de novo . mt-sDNA as an interval test after negative screening colonoscopy warrants further study.

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“…23 This might be particularly important if additional studies confirm that the protective effect of one-time high-quality screening colonoscopy extends well beyond 10 years of follow-up. 24 However, AN detection rates can rise significantly over several rounds of FIT/combined strategy and render the differences between colonoscopy-only strategy and sequential or choice strategies both clinically and statistically significant. Because this was a pragmatic trial, mailed invitations were simple and could fail to provide in-depth decision aids.…”

Section: Discussionmentioning

confidence: 99%

Participation in Competing Strategies for Colorectal Cancer Screening: A Randomized Health Services Study (PICCOLINO Study)

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Long-Term Colorectal Cancer Incidence and Mortality After a Single Negative Screening Colonoscopy

Cited by 78 publications

References 36 publications

Colonoscopist Performance and Colorectal Cancer Risk After Adenoma Removal to Stratify Surveillance: Two Nationwide Observational Studies

Colonoscopist Performance and Colorectal Cancer Risk After Adenoma Removal to Stratify Surveillance: Two Nationwide Observational Studies

Detection of Postcolonoscopy Colorectal Neoplasia by Multi-target Stool DNA

Participation in Competing Strategies for Colorectal Cancer Screening: A Randomized Health Services Study (PICCOLINO Study)

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