Quality of Colonoscopy Is Associated With Adenoma Detection and Postcolonoscopy Colorectal Cancer Prevention in Lynch Syndrome.

Autor:	Sánchez A; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Roos VH; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands., Navarro M; Hereditary Cancer Program, Oncobell Program, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospital Duran i Reynals., Pineda M; Hereditary Cancer Program, Oncobell Program, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospital Duran i Reynals., Caballol B; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Moreno L; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Carballal S; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Rodríguez-Alonso L; Department of Gastroenterology, Hospital Universitari de Bellvitge, Catalan Institute of Oncology, L'Hospitalet, Barcelona, Spain., Ramon Y Cajal T; Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Llort G; Department of Medical Oncology and Gastroenterology, Parc Tauli Hospital Universitari, Conscorci Sanitari de Terrasa, Sabadell-Terrasa, Spain., Piñol V; Department of Gastroenterology, University of Girona, Hospital Dr Josep Trueta, Girona, Spain., López-Fernández A; Department of Medical Oncology, Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain., Salces I; Department of Gastroenterology, Hospital 12 de Octubre, Madrid, Spain., Picó MD; Department of Gastroenterology, Hospital General Universitario de Elche, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Elche, Spain., Rivas L; Department of Gastroenterology, Complexo Hospitalario Universitario de Orense, Instituto de Investigación Sanitaria Galicia Sur, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Ourense, Spain., Bujanda L; Department of Gastroenterology, Biodonostia Health Research Institute, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), San Sebastián, Spain., Garzon M; Department of Gastroenterology, Hospital Virgen del Rocio, Sevilla, Spain., Pizarro A; Department of Gastroenterology, Hospital Virgen del Rocio, Sevilla, Spain., Martinez de Castro E; Department of Medical Oncology and Gastroenterology, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain., López-Arias MJ; Department of Medical Oncology and Gastroenterology, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain., Poves C; Department of Gastroenterology, Hospital Clínico San Carlos, Madrid, Spain., Garau C; Department of Gastroenterology, Hospital Universitario Son Llatzer, Palma de Mallorca, Spain., Rodriguez-Alcalde D; Department of Gastroenterology, Hospital de Móstoles, Móstoles, Spain., Herraiz M; Department of Gastroenterology, Clínica Universidad de Navarra, Pamplona, Spain., Alvarez-Urrutia C; Department of Gastroenterology, Institut Hospital del Mar d'Investigacions Biomèdiques (IMIM), Hospital del Mar Medical Research Institute, Barcelona Hospital del Mar, Barcelona; Spain., Dacal A; Department of Gastroenterology, Hospital Universitario Lucus Augusti, Lugo, Spain., Carrillo-Palau M; Department of Gastroenterology, Hospital Universitario de Canarias, Tenerife, Spain., Cid L; Department of Gastroenterology, Xerencia Xestion Integrada de Vigo, Servizo Galego de Saude (SERGAS), Research Group in Digestive Diseases, Instituto de Investigacion Sanitaria Galicia Sur (IISGS), SERGAS-Universidade de Vigo (UVIGO), Vigo, Spain., Ponce M; Department of Gastroenterology, Hospital Universitario de la Fe de Valencia, Valencia, Spain., Barreiro-Alonso E; Department of Gastroenterology, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain., Saperas E; Department of Gastroenterology, Hospital Universitari General de Catalunya, Sant Cugat, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain., Aguirre E; Genetic Counseling Unit, Department of Medical Oncology, Hospital Quirónsalud Zaragoza, Zaragoza, Spain., Romero C; Department of Medical Oncology and Gastroenterology, Parc Tauli Hospital Universitari, Conscorci Sanitari de Terrasa, Sabadell-Terrasa, Spain., Bastiaansen B; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands., Gonzalez-Acosta M; Hereditary Cancer Program, Oncobell Program, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospital Duran i Reynals., Morales-Romero B; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Ocaña T; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Rivero-Sánchez L; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Jung G; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Bessa X; Department of Gastroenterology, Institut Hospital del Mar d'Investigacions Biomèdiques (IMIM), Hospital del Mar Medical Research Institute, Barcelona Hospital del Mar, Barcelona; Spain., Cubiella J; Department of Gastroenterology, Complexo Hospitalario Universitario de Orense, Instituto de Investigación Sanitaria Galicia Sur, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Ourense, Spain., Jover R; Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Alicante, Spain., Rodríguez-Moranta F; Department of Gastroenterology, Hospital Universitari de Bellvitge, Catalan Institute of Oncology, L'Hospitalet, Barcelona, Spain., Balmaña J; Department of Medical Oncology, Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain., Brunet J; Hereditary Cancer Program, Catalan Institute of Oncology, Institut d'Investigacio Biomèdica de Giron Dr. Josep Trueta (IDIBGI), Medical Sciences Department, School of Medicine, University of Girona, Hospital Dr Josep Trueta, Girona, Spain., Castells A; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Dekker E; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands., Capella G; Hereditary Cancer Program, Oncobell Program, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospital Duran i Reynals., Serra-Burriel M; Center for Research in Health and Economics, Universitat Pompeu Fabra, Barcelona, Spain., Moreira L; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Pellise M; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Balaguer F; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain. Electronic address: fprunes@clinic.cat.
Jazyk:	angličtina
Zdroj:	Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2022 Mar; Vol. 20 (3), pp. 611-621.e9. Date of Electronic Publication: 2020 Nov 03.
DOI:	10.1016/j.cgh.2020.11.002
Abstrakt:	Background & Aims: Colonoscopy reduces colorectal cancer (CRC) incidence and mortality in Lynch syndrome (LS) carriers. However, a high incidence of postcolonoscopy CRC (PCCRC) has been reported. Colonoscopy is highly dependent on endoscopist skill and is subject to quality variability. We aimed to evaluate the impact of key colonoscopy quality indicators on adenoma detection and prevention of PCCRC in LS. Methods: We conducted a multicenter study focused on LS carriers without previous CRC undergoing colonoscopy surveillance (n = 893). Incident colorectal neoplasia during surveillance and quality indicators of all colonoscopies were analyzed. We performed an emulated target trial comparing the results from the first and second surveillance colonoscopies to assess the effect of colonoscopy quality indicators on adenoma detection and PCCRC incidence. Risk analyses were conducted using a multivariable logistic regression model. Results: The 10-year cumulative incidence of adenoma and PCCRC was 60.6% (95% CI, 55.5%-65.2%) and 7.9% (95% CI, 5.2%-10.6%), respectively. Adequate bowel preparation (odds ratio [OR], 2.07; 95% CI, 1.06-4.3), complete colonoscopies (20% vs 0%; P = .01), and pan-chromoendoscopy use (OR, 2.14; 95% CI, 1.15-3.95) were associated with significant improvement in adenoma detection. PCCRC risk was significantly lower when colonoscopies were performed during a time interval of less than every 3 years (OR, 0.35; 95% CI, 0.14-0.97). We observed a consistent but not significant reduction in PCCRC risk for a previous complete examination (OR, 0.16; 95% CI, 0.03-1.28), adequate bowel preparation (OR, 0.64; 95% CI, 0.17-3.24), or previous use of high-definition colonoscopy (OR, 0.37; 95% CI, 0.02-2.33). Conclusions: Complete colonoscopies with adequate bowel preparation and chromoendoscopy use are associated with improved adenoma detection, while surveillance intervals of less than 3 years are associated with a reduction of PCCRC incidence. In LS, high-quality colonoscopy surveillance is of utmost importance for CRC prevention. (Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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