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Interval Advanced Adenomas and Neoplasia in Patients with Negative Colonoscopy Following Positive Stool-Based Colorectal Cancer Screening Test

  • 0Department of Internal Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Digestive Diseases and Sciences +

|

November 24, 2024

|

November 24, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Following a positive fecal occult blood test (FOBT) or fecal immunohistochemical test (FIT) for colorectal cancer screening, a negative colonoscopy indicates a low risk of advanced adenomas. Non-Hispanic white individuals with negative colonoscopies may benefit from closer surveillance.

Area Of Science

  • Gastroenterology
  • Oncology
  • Preventive Medicine

Background

  • Fecal occult blood tests (FOBT) and fecal immunohistochemical tests (FIT) are crucial for colorectal cancer (CRC) screening.
  • The risk of developing advanced adenomas or CRC after a positive FOBT/FIT followed by a negative colonoscopy remains unclear.

Purpose Of The Study

  • To determine the incidence of advanced adenomas or CRC after a negative colonoscopy in patients with a positive FOBT/FIT.
  • To identify risk factors for developing advanced adenomas or CRC in this patient group.

Main Methods

  • A retrospective cohort study identified patients who underwent colonoscopy after a positive FOBT/FIT between 2010 and 2013.
  • Incidence rates of advanced adenomas or CRC were compared between patients with negative and positive index colonoscopies.
  • Cox regression models were used to examine risk factors for incident adenomas.

Main Results

  • Of 2096 patients, 1293 (61.7%) had negative index colonoscopies.
  • The incidence rate of advanced adenomas was significantly higher after positive colonoscopies (2.08 per 100 person-years) compared to negative colonoscopies (0.65 per 100 person-years).
  • Non-Hispanic white race was identified as the strongest risk factor for incident adenomas in patients with negative index colonoscopies.

Conclusions

  • A negative colonoscopy following a positive FOBT/FIT is associated with a low likelihood of developing advanced adenomas and no interval CRC.
  • Non-Hispanic white race is a risk factor for incident adenomas, suggesting these patients may require more intensive surveillance.

Keywords:

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