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Complete colonoscopy rarely misses cancer.
Hooi C Ee1, James B Semmens, Neville E Hoffman
1Department of Gastroenterology, Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia.
Gastrointestinal Endoscopy
|January 31, 2002
Summary
Colonoscopy is highly accurate for detecting colorectal cancer. Studies show a low risk (0.5-0.6%) of cancer developing after a normal colonoscopy examination.
Area of Science:
- Gastroenterology
- Oncology
- Preventive Medicine
Background:
- Assessed the accuracy of colonoscopy in detecting colorectal cancer.
- Investigated cancer incidence after normal colonoscopy findings.
Purpose of the Study:
- To evaluate the risk of colorectal cancer following a normal colonoscopy.
- To validate the diagnostic accuracy of colonoscopy in a real-world setting.
Main Methods:
- Utilized a multicenter endoscopy database to identify patients with normal colonoscopies.
- Followed two cohorts: one via health services data linkage for 5 years, the other by identifying repeat colonoscopies.
- Linked patient data for morbidity, cancer, and mortality.
Main Results:
- In a 5-year follow-up of 1047 patients, 5 cancers (0.5%) were detected, a rate not significantly different from predictions but lower than the overall colonoscopy presentation risk (5.2%).
- In a cohort of 8486 patients, 3 cancers (0.6%) were diagnosed during repeat colonoscopies within an average of 3.1 years.
Conclusions:
- The low incidence of cancer after a normal colonoscopy supports its high accuracy.
- Findings demonstrate a low risk of advanced neoplastic lesions post-normal colonoscopy.