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Area of Science:

  • Oncology
  • Gastroenterology
  • Public Health

Background:

  • A Finnish randomized colorectal cancer (CRC) screening trial (2004-2016) utilized fecal occult blood testing (gFOBT) to refer participants for colonoscopy.
  • This study investigates sex-specific CRC incidence and standardized incidence ratios (SIR) following a positive gFOBT and a negative colonoscopy result.

Purpose of the Study:

  • To assess the sex-specific incidence of colorectal cancer (CRC) after a negative colonoscopy.
  • To evaluate the protective effect of negative colonoscopy in men and women across different follow-up periods.

Main Methods:

  • Utilized data from a Finnish randomized CRC screening trial, linking diagnoses from the Finnish Cancer Registry.
  • Calculated age- and sex-specific SIRs by comparing CRC incidence in the colonoscopy-negative group to the control population.
  • Analyzed three follow-up intervals: 0.5-2 years, 2-6 years, and over 6 years.

Main Results:

  • In men, a negative colonoscopy was associated with significantly lower CRC incidence across all follow-up periods (SIRs ranging from 0.28 to 0.51).
  • In women, the SIRs were not significantly lower than expected in any follow-up period (ranging from 0.83 to 1.63), indicating no significant protective effect from negative colonoscopy.

Conclusions:

  • A negative colonoscopy does not appear to confer the same protective benefit against CRC in women as it does in men.
  • Current guidelines for screening intervals after a negative colonoscopy may require sex-specific considerations.
  • Further research is needed to understand these sex-based differences and explore new screening methods.