{"id":19682,"date":"2024-05-27T11:22:24","date_gmt":"2024-05-27T15:22:24","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=19682"},"modified":"2024-05-27T11:22:25","modified_gmt":"2024-05-27T15:22:25","slug":"duration-of-risk-reduction-in-colorectal-cancer-incidence-and-mortality-after-a-complete-colonoscopy","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/duration-of-risk-reduction-in-colorectal-cancer-incidence-and-mortality-after-a-complete-colonoscopy\/","title":{"rendered":"Duration of risk reduction in colorectal cancer incidence and mortality after a complete colonoscopy in Ontario, Canada: a population-based cohort study"},"content":{"rendered":"

Background<\/strong> \u2014 Colorectal cancer guidelines recommend screening colonoscopy every 10 years after a negative procedure. If risk reduction extends past 10 years, the recommended interval could be extended, reducing the burden on the individual and health-care system. We aimed to estimate the duration that patients remain at reduced risk of colorectal cancer incidence and mortality after a complete colonoscopy.<\/p>\n

Methods<\/strong> \u2014 We did a population-based cohort study of individuals aged 50\u201365 years between Jan 1, 1994, to Dec 31, 2017. We excluded individuals with previous exposure to colonoscopy or colorectal surgery, those previously diagnosed with colorectal cancer, or a history of hereditary or other bowel disorders. We followed up participants until Dec 31, 2018, and identified all colonoscopies performed in this time period. We used a 9-level time-varying measure of exposure, capturing time since last complete colonoscopy (no complete colonoscopy, \u22645 years, >5\u201310 years, >10\u201315 years, and >15 years) and whether an intervention was performed (biopsy or polypectomy). A Cox proportional hazards regression model adjusting for age, sex, comorbidity, residential income quintile, and immigration status was used to estimate the association between exposure to a complete colonoscopy and colorectal cancer incidence and mortality.<\/p>\n

Findings<\/strong> \u2014 5\u2009298\u2009033 individuals (2\u2009609\u2009060 [49\u00b72%] female and 2\u2009688\u2009973 [50\u00b78%] male; no data on ethnicity were available) were included in the cohort, with a median follow-up of 12\u00b756 years (IQR 6\u00b726\u201320\u00b713). 90\u2009532 (1\u00b77%) individuals were diagnosed with colorectal cancer and 44\u2009088 (0\u00b78%) died from colorectal cancer. Compared with those who did not have a colonoscopy, the risk of colorectal cancer in those who had a complete negative colonoscopy was reduced at all timepoints, including when the procedure occurred more than 15 years earlier (hazard ratio [HR] 0\u00b762 [95% CI 0\u00b751\u20130\u00b777] for female individuals and 0\u00b757 [0\u00b746\u20130\u00b770] for male individuals. A similar finding was observed for colorectal cancer mortality, with lower risk at all timepoints, including when the procedure occurred more than 15 years earlier (HR 0\u00b764 [95% CI 0\u00b749\u20130\u00b783] for female participants and 0\u00b765 [0\u00b750\u20130\u00b783] for male participants). Those who had a colonoscopy with intervention had a significantly lower colorectal cancer incidence than those who did not undergo colonoscopy if the procedure occurred within 10 years for females (HR 0\u00b770 [95% CI 0\u00b763\u20130\u00b777]) and up to 15 years for males (0\u00b762 [(0\u00b753\u20130\u00b772]).<\/p>\n

\n

Interpretation<\/strong> \u2014 Compared with those who do not receive colonoscopy, individuals who have a negative colonoscopy result remain at lower risk for colorectal cancer incidence and mortality more than 15 years after the procedure. The current recommendation of repeat screening at 10 years in these individuals should be reassessed.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Background \u2014 Colorectal cancer guidelines recommend screening colonoscopy every 10 years after a negative procedure. If risk reduction extends past 10 years, the recommended interval could be extended, reducing the burden on the individual and health-care system. We aimed to estimate the duration that patients remain at reduced risk of colorectal cancer incidence and mortality […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[38],"migration-helper-qa-sample-set":[],"class_list":["post-19682","journal_article","type-journal_article","status-publish","hentry","topic-cancer-and-cancer-screening"],"acf":{"citation":"Ruco A, Moineddin R, Sutradhar R, Tinmouth J, Li Q, Rabeneck L, Del Giudice ME, Dub\u00e9 C, Baxter NN. 2024; May 5 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1016\/S2468-1253(24)00084-0","ices_scientist":[1370,1109,1177],"site":[6733],"research_program":[6741],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | Duration of risk reduction in colorectal cancer incidence and mortality after a complete colonoscopy in Ontario, Canada: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Colorectal cancer guidelines recommend screening colonoscopy every 10 years after a negative procedure. 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