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CC BY 4.0 · Endoscopy 2023; 55(12): 1061-1069
DOI: 10.1055/a-2136-6564
Original article

Interval post-colonoscopy colorectal cancer following a negative colonoscopy in a fecal immunochemical test-based screening program

Hilliene J. van de Schootbrugge-Vandermeer  ‡   ‡
1   Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Arthur I. Kooyker  ‡   ‡
1   Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Pieter H. A. Wisse
2   Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Iris D. Nagtegaal
3   Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
,
Hiltje A. Geuzinge
1   Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Esther Toes-Zoutendijk 
1   Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Lucie de Jonge
1   Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Emilie C. H. Breekveldt
1   Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
4   Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
,
Anneke J. van Vuuren
2   Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Folkert J. van Kemenade
5   Department of Pathology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Christian R. B. Ramakers
6   Department of Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Evelien Dekker 
7   Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
,
Iris Lansdorp-Vogelaar
1   Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Manon C. W. Spaander  ‡   ‡
2   Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Monique E. van Leerdam‡   ‡
4   Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
8   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
› InstitutsangabenGefördert durch: Rijksinstituut voor Volksgezondheid en Milieu 4410002642
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Einführung zu diesem Artikel:

Positive fecal immunochemical test but negative colonoscopy: what’s next?Endoscopy 2023; 55(12): 1070-1071
DOI: 10.1055/a-2182-6316

Einführung zu diesem Artikel:

Author commentary on Hilliene J. van de Schootbrugge-Vandermeer et al.Endoscopy 2023; 55(12): v41-v41
DOI: 10.1055/a-2160-6868

Abstract

Background In the Dutch colorectal (CRC) screening program, fecal immunochemical test (FIT)-positive individuals are referred for colonoscopy. If no relevant findings are detected at colonoscopy, individuals are reinvited for FIT screening after 10 years. We aimed to assess CRC risk after a negative colonoscopy in FIT-positive individuals.

Methods In this cross-sectional cohort study, data were extracted from the Dutch national screening information system. Participants with a positive FIT followed by a negative colonoscopy between 2014 and 2018 were included. A negative colonoscopy was defined as a colonoscopy during which no more than one nonvillous, nonproximal adenoma < 10 mm or serrated polyp < 10 mm was found. The main outcome was interval post-colonoscopy CRC (iPCCRC) risk. iPCCRC risk was reviewed against the risk of interval CRC after a negative FIT (FIT IC) with a 2-year screening interval.

Results 35 052 FIT-positive participants had a negative colonoscopy and 24 iPCCRCs were diagnosed, resulting in an iPCCRC risk of 6.85 (95 %CI 4.60–10.19) per 10 000 individuals after a median follow-up of 1.4 years. After 2.5 years of follow-up, age-adjusted iPCCRC risk was approximately equal to FIT IC risk at 2 years.

Conclusion Risk of iPCCRC within a FIT-based CRC screening program was low during the first years after colonos-copy but, after 2.5 years, was the same as the risk in FIT-negative individuals at 2 years, when they are reinvited for screening. Colonoscopy quality may therefore require further improvement and FIT screening interval may need to be reduced after negative colonoscopy.

‡ Authors contributed equally


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Publikationsverlauf

Eingereicht: 02. September 2022

Angenommen nach Revision: 07. Juli 2023

Artikel online veröffentlicht:
04. Oktober 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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