Colonoscopy more than 10 months after positive FIT increases risk of colorectal cancer and more advanced-stage disease
Clinical Question
Does the time of follow-up colonoscopy after a positive fecal immunochemical test affect the risk of colon cancer and more advanced-stage disease?
Bottom Line
In adults with a positive fecal immunochemical test (FIT) result, there are no differences in colorectal cancer outcomes if the follow-up colon examination occurs within 6 months. Follow-up colon examination from 6 months to 10 months is associated with an increased risk of stage II colorectal cancer. Follow-up after 10 months is significantly associated with an increased risk of advanced-stage disease, including stage IV colorectal cancer. (LOE = 2b)
Reference
Corley DA, Jensen CD, Quinn VP, et al. Association between time to colonoscopy after a positive fecal test result and risk of colorectal cancer and cancer stage at diagnosis. JAMA 2017;317(16):1631-1641. [PMID:28444278]
Study Design
Cohort (retrospective)
Funding
Government
Setting
Population-based
Synopsis
These invesigators retrospectively analyzed data obtained from a large health care system in California on adults, aged 50 to 75 years, with a positive screening FIT result and a subsequent referral for colonoscopy scheduling. Exclusion criteria included a history of colon cancer, less than a year of membership in the system and no record of a colonoscopy since enrollment, a colonoscopy within less than 10 years or sigmoidoscopy within less than 5 years, and colonoscopy or colorectal cancer diagnosis within 1 to 7 days after the positive FIT result. Of the eligible participants with a positive FIT result (N = 81,518), 86% received a follow-up colonoscopy. Of these 33.3% received a colonoscopy within 30 days, 63.6% within 2 months, 74.2% within 3 months, 80.6% within 6 months, and 83.2% within 12 months. No significant differences occurred in the risk of colorectal cancer with follow-up colonoscopy within 6 months compared with follow-up between 8 days and 30 days. For those patients with follow-up from 7 months to 9 months, the risk of stage II colorectal cancer was significantly increased compared with the patients with follow-up in less than 30 days (12 vs 9 cases per 1000 patients). For follow-up colonoscopy at 10 months to 12 months the risk of any colorectal cancer was significantly increased (49 cases per 1000 patients), as was advanced-stage disease (19 cases per 1000 patients) and stage IV colorectal cancer (7 cases per 1000 patients). Risks were even more significantly increased with follow-up examinations more than 12 months after initial FIT.
Colonoscopy more than 10 months after positive FIT increases risk of colorectal cancer and more advanced-stage diseaseis the Evidence Central Word of the day!
Citation
Barry, Henry, et al., editors. "Colonoscopy More Than 10 Months After Positive FIT Increases Risk of Colorectal Cancer and More Advanced-stage Disease." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/1314267/all/Colonoscopy_more_than_10_months_after_positive_FIT_increases_risk_of_colorectal_cancer_and_more_advanced_stage_disease.
Colonoscopy more than 10 months after positive FIT increases risk of colorectal cancer and more advanced-stage disease. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/1314267/all/Colonoscopy_more_than_10_months_after_positive_FIT_increases_risk_of_colorectal_cancer_and_more_advanced_stage_disease. Accessed October 22, 2024.
Colonoscopy more than 10 months after positive FIT increases risk of colorectal cancer and more advanced-stage disease. (2019). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/1314267/all/Colonoscopy_more_than_10_months_after_positive_FIT_increases_risk_of_colorectal_cancer_and_more_advanced_stage_disease
Colonoscopy More Than 10 Months After Positive FIT Increases Risk of Colorectal Cancer and More Advanced-stage Disease [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2024 October 22]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/1314267/all/Colonoscopy_more_than_10_months_after_positive_FIT_increases_risk_of_colorectal_cancer_and_more_advanced_stage_disease.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Colonoscopy more than 10 months after positive FIT increases risk of colorectal cancer and more advanced-stage disease
ID - 1314267
ED - Barry,Henry,
ED - Ebell,Mark H,
ED - Shaughnessy,Allen F,
ED - Slawson,David C,
BT - EE+ POEM Archive
UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/1314267/all/Colonoscopy_more_than_10_months_after_positive_FIT_increases_risk_of_colorectal_cancer_and_more_advanced_stage_disease
PB - John Wiley & Sons
DB - Evidence Central
DP - Unbound Medicine
ER -