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Time To Colonoscopy After Abnormal Stool-based Screening And Risk For Colorectal Cancer Incidence And Mortality.

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Time To Colonoscopy After Abnormal Stool-based Screening And Risk For Colorectal Cancer Incidence And Mortality.

Related Experiment Video

Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection

Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection

Published on: June 8, 2020

Time to Colonoscopy After Abnormal Stool-Based Screening and Risk for Colorectal Cancer Incidence and Mortality.

Yazmin San Miguel¹, Joshua Demb², Maria Elena Martinez³

¹Division of Gastroenterology, Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California; Moores Cancer Center and Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.

Gastroenterology

|February 5, 2021

View abstract on PubMed

Summary

This summary is machine-generated.

Delaying diagnostic colonoscopy after an abnormal stool test increases colorectal cancer (CRC) risk and mortality. Prompt follow-up within one year is crucial for better CRC outcomes.

Keywords:

Prevention Quality Veterans Affairs

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Published on: October 16, 2013

Area of Science:

Gastroenterology
Oncology
Public Health

Background:

The optimal timeframe for diagnostic colonoscopy after abnormal stool-based colorectal cancer (CRC) screening is not well-defined.
Stool-based tests like fecal occult blood tests (FOBT) and fecal immunochemical tests (FIT) are common CRC screening methods.
Timely follow-up colonoscopy is essential for early detection and improved outcomes in individuals with positive screening results.

Purpose of the Study:

To investigate the association between the time interval to diagnostic colonoscopy and CRC incidence and mortality.
To examine the relationship between delayed colonoscopy and the risk of late-stage CRC diagnosis following abnormal stool screening.
To provide evidence-based recommendations for optimal follow-up intervals after positive CRC screening tests.

Main Methods:

Retrospective cohort study of 204,733 US veterans aged 50-75 years with abnormal FOBT or FIT results between 1999 and 2010.
Multivariable Cox proportional hazards models were used to calculate CRC-specific incidence and mortality hazard ratios (HRs) for 3-month colonoscopy intervals.
The association between time to colonoscopy and late-stage CRC diagnosis was also analyzed.

Main Results:

Compared to colonoscopy within 1-3 months, delayed colonoscopy was associated with increased CRC risk, particularly after 12 months.
Significant increases in CRC incidence were observed for colonoscopy intervals of 13-15 months (HR 1.13), 16-18 months (HR 1.25), 19-21 months (HR 1.28), and 22-24 months (HR 1.26).
Higher mortality risk was noted for colonoscopy intervals of 19-21 months (HR 1.52) and 22-24 months (HR 1.39).
The odds of a late-stage CRC diagnosis increased significantly starting at 16 months post-abnormal screening.

Conclusions:

Extended time to colonoscopy following an abnormal stool-based CRC screening test is linked to a higher risk of CRC incidence, mortality, and late-stage diagnosis.
Diagnostic follow-up colonoscopy should be prioritized within one year of an abnormal FIT or FOBT result to improve patient outcomes.
Interventions aimed at reducing delays in diagnostic colonoscopy are warranted to enhance CRC detection and management.