Delayed Colonoscopy Following a Positive Fecal Test Result and Cancer Mortality

JNCI Cancer Spectrum
Anath A FlugelmanLital Keinan-Boker

Abstract

A fecal test followed by diagnostic colonoscopy for a positive result is a widely endorsed screening strategy for colorectal cancer (CRC). However, the relationship between the time delay from the positive test to the follow-up colonoscopy and CRC mortality has not been established. From a population-based screening program, we identified CRC patients newly diagnosed from 2005 through 2015 by a positive fecal occult test followed by a colonoscopy. The primary outcome measure was CRC-specific mortality according to four categories for the time elapsed between the positive result and the subsequent colonoscopy. The 1749 patients underwent colonoscopies within 0-3 months (n = 981, 56.1%), 4-6 months (n = 307, 17.5%), 7-12 months (n = 157, 9.0%), and later than 12 months (n = 304, 17.4%). CRC-specific deaths according to exposure groups were: 13.8% (135 of 981) for 0-3 months, 10.7% (33 of 307) for 4-6 months (crude hazards ratio [HR] = 0.74, 95% confidence interval [CI] = 0.51 to 1.14), 11.5% (18 of 157) for 7-12 months (crude HR = 0.83, 95% CI = 0.51 to 1.42), and 22.7% (69 of 304) for longer than 12 months (crude HR = 1.40, 95% CI = 1.04 to 1.90). The only variable that was associated with mortality risk was the number of positi...Continue Reading

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Citations

Sep 16, 2020·Journal of Internal Medicine·R Hultcrantz
Mar 5, 2020·Journal of General Internal Medicine·Vivy T Cusumano, Folasade P May
Nov 20, 2020·Annual Review of Medicine·Chyke A DoubeniSamir Gupta
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Mar 1, 2021·Gastroenterology·Anath A Flugelman, Øyvind Holme
Oct 4, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Nauzer ForbesSteven J Heitman

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