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 17 October 2017

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News

Time to colonoscopy after a positive fecal test associated with colorectal cancer risk

This week's issue of the Journal of the American Medical Association investigated whether time to colonoscopy after a positive fecal immunochemical test result is associated with an increased risk of colorectal cancer.

News image

The fecal immunochemical test is commonly used for colorectal cancer screening and positive test results require follow-up colonoscopy. 

However, follow-up intervals vary, which may result in neoplastic progression.

Dr Douglas Corley and colleagues evaluated time to colonoscopy after a positive fecal immunochemical test result, and its association with risk of colorectal cancer and advanced-stage disease at diagnosis.

The research team performed a retrospective cohort study within Kaiser Permanente Northern and Southern California. 

Participants were 70,124 patients aged 50 through 70 years eligible for colorectal cancer screening with a positive fecal immunochemical test result who had a follow-up colonoscopy.

Risks were higher for examinations at 10 to 12 months for any colorectal cancer
Journal of the American Medical Association
The team evaluated days to colonoscopy after a positive fecal immunochemical test result.

The researchers' main outcomes included risk of any colorectal cancer and advanced-stage disease. 

Of the 70,124 patients with positive fecal immunochemical test results, the team identified 2191 cases of any colorectal cancer, and 601 cases of advanced-stage disease diagnosed. 

The research team found that, compared with colonoscopy follow-up within 8 to 30 days, there were no significant differences between follow-up at 2 months, 3 months, 4 to 6 months, or 7 to 9 months for risk of any colorectal cancer or advanced-stage disease.

The team observed that risks were significantly higher for examinations at 10 to 12 months for any colorectal cancer, and advanced-stage disease, and more than 12 months for any colorectal cancer, and advanced-stage disease.

Dr Corley's team comments, "Among patients with a positive fecal immunochemical test result, compared with follow-up colonoscopy at 8 to 30 days, follow-up after 10 months was associated with a higher risk of colorectal cancer and more advanced-stage disease at the time of diagnosis."

"Further research is needed to assess whether this relationship is causal."

JAMA 2017:317(16): 1631-1641
26 April 2017

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