Colorectal cancer mortality reduction is associated with having at least 1 colonoscopy within the previous 10 years among a population-wide cohort of screening age

Gastrointestinal Endoscopy
David StockLinda Rabeneck

Abstract

Colonoscopy has been demonstrated to be effective in colorectal cancer (CRC) mortality reduction, although current screening guidelines have yet to be evaluated. We assessed the protective benefit of colonoscopy within the previous 10 years and whether this effect is maintained with age. We used administrative data to compare risk of CRC death (CCD) across colonoscopy utilization among a population-wide cohort comprising individuals aged 60 to 80 years (N = 1,509,423). Baseline and time-dependent colonoscopy exposure models were assessed in the context of competing "other causes of death" (OCDs). Cumulative incidence of CCD and OCD across colonoscopy exposure, over follow-up, was estimated. Relative hazards were computed by age strata (60-69 years, 70-74 years, 75+ years) and proximal and distal cancer subsites. At least 1 colonoscopy during 10 years before baseline was estimated to provide a 51% reduced hazard of CCD (hazard ratio [HR] 0.49; 95% confidence interval [CI], 0.45-0.54) over the following 8 years. When colonoscopy was modeled as a time-dependent covariate, the risk of CCD was further diminished (multivariable-adjusted HR 0.36; 95% CI, 0.33-0.38). Stratified analyses suggested moderately attenuated CCD risk reductio...Continue Reading

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Citations

Jun 28, 2016·Best Practice & Research. Clinical Gastroenterology·A RucoL Rabeneck
Jan 25, 2019·Proceedings of the National Academy of Sciences of the United States of America·Alan R BaudronAsta Audzijonyte
Jul 20, 2020·International Journal of Cancer. Journal International Du Cancer·Aysel AhadovaMatthias Kloor
Jul 28, 2017·European Journal of Epidemiology·Xabier García-AlbénizMiguel A Hernán

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