Risk of colorectal cancer for fecal immunochemistry test‐positive, average‐risk patients after a colonoscopy. Issue 3 (18th November 2018)

• Record Type: Journal Article
• Authors: Kawamura, Takuji; Nakamura, Shiho; Sone, Daiki; Sakai, Hiroaki; Amamiya, Kana; Inoue, Naonori; Sakiyama, Naokuni; Shirakawa, Atsushi; Okada, Yusuke; Sanada, Kasumi; Nakase, Kojiro; Mandai, Koichiro; Suzuki, Azumi; Morita, Atsuhiro; Tanaka, Kiyohito; Uno, Koji; Yasuda, Kenjiro
• Is Part Of: Journal of gastroenterology and hepatology. Volume 34:Issue 3(2019)
• Page Start: 532
• Page End: 536
• Publication Date: 2018-11-18
• Subjects: cancer screening -- colonoscopy -- colorectal neoplasms -- occult blood; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.14517
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: Because the risk of colorectal cancer has not been well examined in fecal immunochemistry test (FIT)‐positive patients who previously underwent colonoscopy, this study aimed to investigate this topic. Methods: This was a single‐center, observational study of prospectively collected data in Japan. FIT‐positive, average‐risk patients who underwent colonoscopy were divided into groups as follows: those who never underwent colonoscopy in the past (no colonoscopy group), those with a history of colonoscopy between 6 months and 5 years (0.5‐ to 5‐year colonoscopy group), and those with a history of colonoscopy more than 5 years ago (> 5‐year colonoscopy group). We investigated the prevalence of advanced neoplasia and invasive cancer among these groups using multiple logistic regression analysis. Results: Detection rates of advanced neoplasia in the no colonoscopy group, 0.5‐ to 5‐year colonoscopy group, and > 5‐year colonoscopy group were 14.8% (240/1626), 3.9% (13/330), and 6.9% (17/248), respectively. Detection rates of invasive cancer in each aforementioned group were 5.7% (92/1, 626), 0.3% (1/330), and 1.2% (3/248), respectively. Odds ratios of advanced neoplasia in the 0.5‐ to 5‐year colonoscopy group and > 5‐year colonoscopy were 0.23 (95% confidence interval [CI]: 0.13–0.42) and 0.40 (95% CI: 0.24–0.68), respectively, in multivariate analysis. The odds ratios of invasive cancer in each aforementioned group were 0.05 (95% CI: 0.01–0.37) and 0.19 (95% CI: 0.06–0.61), respectively. Conclusion: Re‐screening with the FIT should not be recommended for at least 5 years for average‐risk patients after colonoscopy without high‐risk neoplasms, because the risks of colorectal cancer are low in such patients.