Five year colorectal cancer outcomes in a large negative CT colonography screening cohort
- 305 Downloads
To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist.
Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded.
Of the 1,050 cohort (mean [±SD] age 56.9 ± 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 ± 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review.
Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate.
• CT colonography (CTC) screening is increasingly used to identify potential colorectal cancer.
• Clinically presenting cancers are rare for 5 years following negative CTC screening.
• The practice of setting a 6 mm polyp size threshold seems safe.
• An interval of 5 years for routine CTC screening is appropriate.
KeywordsCT colonography Gastrointestinal Screening Adenocarcinoma Advanced adenoma
This work was supported in part by the research grant 1R01CA144835-01 from the National Cancer Institute. D.H.K is a consultant for Viatronix, co-founder of VirtuoCTC, and a member of the medical advisory board for Digital Artforms. P.J.P is a consultant for Viatronix, Medicsight, Bracco, and Check-cap, and is a co-founder of VirtuoCTC.
- 5.Levin B, Lieberman DA, McFarland B et al (2008) Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 58:130–160PubMedCrossRefGoogle Scholar
- 11.Ahlbom A (1993) Biostatistics for epidemiologists. CRC, Boca RatonGoogle Scholar