Repeat-screening colonoscopy 5 years after normal baseline-screening colonoscopy in average-risk Chinese: a...

Area of Science:

• Gastroenterology
• Oncology
• Preventive Medicine

Background:

• Colonoscopy is the gold standard for colorectal cancer screening.
• Optimal screening intervals after a negative colonoscopy are not well-established, especially for average-risk populations.
• Understanding the risk of advanced neoplasia in Chinese subjects is crucial for personalized screening.

Purpose of the Study:

• To determine the 5-year risk of advanced neoplasia in average-risk Chinese subjects following a negative screening colonoscopy.
• To identify factors associated with the development of advanced neoplasia at rescreening.

Main Methods:

• A cohort of asymptomatic, average-risk Chinese subjects (aged 55-75) underwent repeat colonoscopy after 5 years.
• Baseline colonoscopy findings were used to categorize subjects.
• Rates of advanced colorectal neoplasia were assessed at the 5-year follow-up.

Main Results:

• In subjects with no baseline polyps, 1.4% developed advanced neoplasia at 5-year rescreening (Number Needed to Rescreen: 74).
• Subjects with baseline advanced neoplasia had a 20.7% prevalence of advanced neoplasia at 5 years (Relative Risk: 19.6).
• Independent predictors for advanced neoplasia at 5 years included baseline advanced neoplasia (OR 13.1) and age (OR 1.11).

Conclusions:

• The risk of developing advanced neoplasia 5 years after a normal screening colonoscopy is low in Chinese subjects.
• Baseline advanced neoplasia and older age are significant risk factors for developing advanced neoplasia.
• These findings support tailored screening intervals based on individual risk factors.