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The incidence of post-colonoscopy colorectal cancer: a retrospective long-term cohort study using a colonoscopy database

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The cumulative incidence of post-colonoscopy colorectal cancer remains unclear. Our aims were to estimate the incidence of and identify risk factors associated with post-colonoscopy colorectal cancer.

Methods

We conducted a retrospective cohort study using the colonoscopy database of the Department of Gastroenterology, the University of Tokyo Hospital Records from1995–2012. A cohort of 2544 patients, who received multiple colonoscopies without colorectal cancer findings at first colonoscopy, was selected. The primary outcome was post-colonoscopy colorectal cancer; data were censored at the date of final colonoscopy. We assessed patients’ background characteristics, colonoscopy findings, and cancer characteristics, including location and size. The cumulative incidence of colorectal cancer was evaluated, and a Cox proportional hazards model was used to estimate hazard ratios (HRs).

Results

Colorectal cancer was identified in seven (0.77/1000 person-years) patients during the mean follow-up period of 3.6 years (maximum, 17 years). The cumulative incidence of colorectal cancer was 0, 0.47, 0.62, and 0.62% at 1, 5, 10, and 15 years, respectively. Cancer was identified in the rectum in five of seven patients. Polyp size >10 mm (HR 5.7, p = 0.023) and intubation time >30 min (HR 11.6, p = 0.003) at first colonoscopy were associated significantly with an increased incidence of post-colonoscopy colorectal cancer.

Conclusions

Although several factors were associated with an increased risk of post-colonoscopy colorectal cancer, the incidence of this disease might be low in patients who received at least twice colonoscopy. High proportion of rectal cancer in post-colonoscopy colorectal cancer should be noted.

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References

  1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127:2893–2917

    Article  CAS  PubMed  Google Scholar 

  2. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90

    Article  PubMed  Google Scholar 

  3. Rapuri S, Spencer J, Eckels D (2008) Importance of postpolypectomy surveillance and postpolypectomy compliance to follow-up screening--review of literature. Int J Color Dis 23:453–459

    Article  Google Scholar 

  4. Klabunde CN, Lanier D, Nadel MR, McLeod C, Yuan G, Vernon SW (2009) Colorectal cancer screening by primary care physicians: recommendations and practices, 2006-2007. Am J Prev Med 37:8–16

    Article  PubMed  PubMed Central  Google Scholar 

  5. le Clercq CM, Bouwens MW, Rondagh EJ, Bakker CM, Keulen ET, de Ridder RJ, Winkens B, Masclee AA, Sanduleanu S (2014) Postcolonoscopy colorectal cancers are preventable: a population-based study. Gut 63:957–963

    Article  PubMed  Google Scholar 

  6. Singh S, Singh PP, Murad MH, Singh H, Samadder NJ (2014) Prevalence, risk factors, and outcomes of interval colorectal cancers: a systematic review and meta-analysis. Am J Gastroenterol 109:1375–1389

    Article  PubMed  Google Scholar 

  7. Singh H, Nugent Z, Demers AA, Bernstein CN (2010) Rate and predictors of early/missed colorectal cancers after colonoscopy in Manitoba: a population-based study. Am J Gastroenterol 105:2588–2596

    Article  PubMed  Google Scholar 

  8. Baxter NN, Sutradhar R, Forbes SS, Paszat LF, Saskin R, Rabeneck L (2011) Analysis of administrative data finds endoscopist quality measures associated with postcolonoscopy colorectal cancer. Gastroenterology 140:65–72

    Article  PubMed  Google Scholar 

  9. Bressler B, Paszat LF, Chen Z, Rothwell DM, Vinden C, Rabeneck L (2007) Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology 132:96–102

    Article  PubMed  Google Scholar 

  10. Strock P, Mossong J, Scheiden R, Weber J, Heieck F, Kerschen A (2011) Colorectal cancer incidence is low in patients following a colonoscopy. Dig Liver Dis 43:899–904

    Article  PubMed  Google Scholar 

  11. Singh H, Turner D, Xue L, Targownik LE, Bernstein CN (2006) Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies. JAMA 295:2366–2373

    Article  CAS  PubMed  Google Scholar 

  12. Lieberman DA, Weiss DG, Harford WV, Ahnen DJ, Provenzale D, Sontag SJ, Schnell TG, Chejfec G, Campbell DR, Kidao J, Bond JH, Nelson DB, Triadafilopoulos G, Ramirez FC, Collins JF, Johnston TK, McQuaid KR, Garewal H, Sampliner RE, Esquivel R, Robertson D (2007) Five-year colon surveillance after screening colonoscopy. Gastroenterology 133:1077–1085

    Article  PubMed  Google Scholar 

  13. Matsuda T, Fujii T, Sano Y, Kudo SE, Oda Y, Igarashi M, Iishi H, Murakami Y, Ishikawa H, Shimoda T, Kaneko K, Yoshida S (2009) Five-year incidence of advanced neoplasia after initial colonoscopy in Japan: a multicenter retrospective cohort study. Jpn J Clin Oncol 39:435–442

    Article  PubMed  Google Scholar 

  14. Cooper GS, Xu F, Barnholtz Sloan JS, Schluchter MD, Koroukian SM (2012) Prevalence and predictors of interval colorectal cancers in medicare beneficiaries. Cancer 118:3044–3052

    Article  PubMed  Google Scholar 

  15. Sanduleanu S, Masclee AM, Meijer GA (2012) Interval cancers after colonoscopy-insights and recommendations. Nat Rev Gastroenterol Hepatol 9:550–554

    Article  PubMed  Google Scholar 

  16. Samadder NJ, Curtin K, Tuohy TM, Pappas L, Boucher K, Provenzale D, Rowe KG, Mineau GP, Smith K, Pimentel R, Kirchhoff AC, Burt RW (2014) Characteristics of missed or interval colorectal cancer and patient survival: a population-based study. Gastroenterology 146:950–960

    Article  PubMed  Google Scholar 

  17. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    Article  CAS  PubMed  Google Scholar 

  18. Corley DA, Jensen CD, Marks AR (2011) Can we improve adenoma detection rates? A systematic review of intervention studies. Gastrointest Endosc 74:656–665

    Article  PubMed  Google Scholar 

  19. Yamada A, Watabe H, Takano N, Togo G, Yamaji Y, Yoshida H, Kawabe T, Omata M, Koike K (2013) Utility of single and double balloon endoscopy in patients with difficult colonoscopy: a randomized controlled trial. World J Gastroenterol 19:4732–4736

    Article  PubMed  PubMed Central  Google Scholar 

  20. Erichsen R, Baron JA, Stoffel EM, Laurberg S, Sandler RS, Sorensen HT (2013) Characteristics and survival of interval and sporadic colorectal cancer patients: a nationwide population-based cohort study. Am J Gastroenterol 108:1332–1340

    Article  PubMed  Google Scholar 

  21. le Clercq CM, Sanduleanu S (2014) Interval colorectal cancers: what and why. Curr Gastroenterol Rep 16:375

    Article  PubMed  Google Scholar 

  22. Farrar WD, Sawhney MS, Nelson DB, Lederle FA, Bond JH (2006) Colorectal cancers found after a complete colonoscopy. Clin Gastroenterol Hepatol 4:1259–1264

    Article  PubMed  Google Scholar 

  23. Quallick MR, Brown WR (2009) Rectal perforation during colonoscopic retroflexion: a large, prospective experience in an academic center. Gastrointest Endosc 69:960–963

    Article  PubMed  Google Scholar 

  24. Adler J, Robertson DJ (2015) Interval colorectal cancer after colonoscopy: exploring explanations and solutions. Am J Gastroenterol 110:1657–1664

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1138655, Japan

    Ayako Nakada, Ryota Niikura, Atsuo Yamada, Shuntaro Yoshida, Yoshihiro Hirata & Kazuhiko Koike

  2. Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan

    Shuntaro Yoshida

Authors
  1. Ayako Nakada
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  2. Ryota Niikura
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  3. Atsuo Yamada
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  4. Shuntaro Yoshida
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  5. Yoshihiro Hirata
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  6. Kazuhiko Koike
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Corresponding author

Correspondence to Atsuo Yamada.

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Nakada, A., Niikura, R., Yamada, A. et al. The incidence of post-colonoscopy colorectal cancer: a retrospective long-term cohort study using a colonoscopy database. Int J Colorectal Dis 32, 839–845 (2017). https://doi.org/10.1007/s00384-017-2757-0

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  • DOI: https://doi.org/10.1007/s00384-017-2757-0

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