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 26 July 2016

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News

Missed colorectal cancers after colonoscopy in older patients

This month's issue of the American Journal of Gastroenterology exmines the rate of early or missed colorectal cancers after colonoscopy in older patients with or without inflammatory bowel disease in the United States.

News image

Patients with inflammatory bowel disease (IBD) have an increased risk for colorectal cancer.

Previous studies on early/missed CRCs after colonoscopy excluded IBD patients.

Dr Yize Wang and colleagues compared the rate of early/missed colorectal cancers after colonoscopy among IBD and non-IBD patients, and identified factors associated with early/missed colorectal cancer.

All patients in the Surveillance, Epidemiology and End-Results Medicare-linked database who were 67 years or older at colonoscopy during 19982005, and those who were subsequently diagnosed with colorectal cancer within 36 months were identified.

Colorectal cancers diagnosed within 6 months of colonoscopy were categorized as detected colorectal cancers.

The rate of early/missed colorectal cancers was 6% for non-IBD patients
American Journal of Gastroenterology

The team diagnosed colorectal cancers 636 months after colonoscopy were categorized as early/missed colorectal cancers.

The research team rated early/missed colorectal cancers was calculated as number of early/missed colorectal cancers divided by number of detected, and early/missed colorectal cancers.
 
Of 55,008 colorectal cancers patients, the rate of early/missed colorectal cancers was 6% for non-IBD patients, 15% for Crohn's, and 16% for ulcerative colitis.

Compared with older non-IBD patients, early/missed colorectal cancers among older IBD patients were less likely right-sided.

The researchers found that the risk of early/missed colorectal cancers was 3 times as high for IBD patients.

Sensitivity analyses confirmed the robustness of this finding.

Dr Wang's team commented, "Older IBD patients had a higher rate of early/missed colorectal cancers after colonoscopy. Our finding supports intensive surveillance colonoscopy for older IBD patients as recommended by guidelines."

Am J Gastroenterol 2013; 108: 444449
22 March 2013

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