Baseline Colonoscopy Findings Associated With 10-Year Outcomes in a Screening Cohort Undergoing Colonoscopy Surveillance
| Autor: | Reana Thomas, Laura W. Musselwhite, David A. Lieberman, Ashton Madison, Brian Sullivan, Dawn Provenzale, Meghan C. O'Leary, A. Jasmine Bullard, Elizabeth R. Hauser, Kellie J. Sims, Xuejun Qin, Douglas J. Robertson, Ziad F. Gellad, Samir Gupta, Thomas S. Redding, Christina D. Williams, Terry Hyslop, David S. Weiss |
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| Rok vydání: | 2020 |
| Předmět: |
education.field_of_study
medicine.medical_specialty Hepatology medicine.diagnostic_test business.industry Colorectal cancer Incidence (epidemiology) Population Gastroenterology Colonoscopy Odds ratio medicine.disease Internal medicine Cohort Medicine Cumulative incidence business education Veterans Affairs |
| Zdroj: | Gastroenterology. 158:862-874.e8 |
| ISSN: | 0016-5085 |
| Popis: | Background & Aims Few studies have evaluated long-term outcomes of ongoing colonoscopic screening and surveillance in a screening population. We aimed to determine the 10-year risk for advanced neoplasia (defined as adenomas ≥10mm, adenomas with villous histology or high-grade dysplasia, or colorectal cancer [CRC]) and assessed whether baseline colonoscopy findings were associated with long-term outcomes. Methods We collected data from the Department of Veterans Affairs Cooperative Studies Program Study on 3121 asymptomatic veterans (50–75 years old) who underwent a screening colonoscopy from 1994 through 1997 at 13 medical centers and were then followed for 10 years or until death. We included 1915 subjects with at least 1 surveillance colonoscopy and estimated cumulative incidence of advanced neoplasia by Kaplan-Meier curves. We then fit a longitudinal joint model to estimate risk of advanced neoplasia at each subsequent examination after baseline, adjusting for multiple colonoscopies within individuals. Results Through 10 years of follow-up, there were 146 individuals among all baseline colonoscopy groups found to have at least 1 incident advanced neoplasia. The cumulative 10-year incidence of advanced neoplasia was highest among those with baseline CRC (43.7%; 95% CI 13.0%–74.4%), followed by those with baseline advanced adenoma (AA) (21.9%; 95% CI 15.7–28.1). The cumulative 10-year incidence of advanced neoplasia was 6.3% (95% CI 4.1%–8.5%) and 4.1% (95% CI 2.7%–5.4%) for baseline 1 to 2 small adenomas ( Conclusions Baseline screening colonoscopy findings associate with advanced neoplasia within 10 years. Individuals with only 1 or 2 small adenomas at baseline have a low risk of advanced neoplasia over 10 years. Alternative surveillance strategies, could be considered for these individuals. |
| Databáze: | OpenAIRE |
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