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Rescreening interval after initial negative colonoscopy may be extended beyond 10 years
Clinical Question
What is the rate of identification of colorectal cancer 10 or more years after an initial negative screening colonoscopy?
Bottom line
Rates of colon cancer prevalence 14 years or longer after an initial negative colonoscopy are only slightly increased (1.3 percentage points) over rates occurring at 10 years. Current recommendations for every-10-year screening for colon cancer with colonoscopy can likely be extended. And rescoping within 10 years makes even less sense. Until national guidelines change, maybe we should continue to offer repeat colonoscopy every 10 years but don’t push too hard. 1b
Reference
Study design: Cohort (prospective)
Funding: Government
Setting: Population-based
Synopsis
These researchers used a registry of screening colonoscopy in Germany, which captures data on 90% of adults. They identified patients who were screened after age 55 years and had a follow-up colonoscopy 10 years or later after the initial screening (49% of the initial cohort). The included patients had no findings (71.1%) or non-neoplastic findings (28.9%) at the time of initial screening. At follow-up, advanced colorectal cancer was identified in 3.6% of women and 5.2% of men tested at 10 years, gradually increasing to 4.9% and 6.6% 14 years or longer after the initial negative screening. These rates were lower than the overall rate of neoplasia found among all people receiving colonoscopy (7.1% for women and 11.6% for men).
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Impact assessment
Very good
Rescreening colonoscopy after great than 10 years
It would be interesting to expand the scope of this review by taking into account the use of FIT testing which could extend (or eliminate) need for rescreening http://www.arisplace.ca/ altogether.
Re-Screening Colonoscopy
Is that with adjuvant FITs @ 2yr intervals or none at all?
FIT followup
In setting of repeat colonoscopy being 10 years or longer, is FIT necessary or appropriate during the intervening period?