Buscar
image du produit
Gastrointestinal Endoscopy

Suscribirse

Protective association of colonoscopy against proximal and distal colon cancer and patterns in interval cancer - 13/08/15

Doi : 10.1016/j.gie.2015.01.053 
Amandeep K. Shergill, MD, MS 1, ⁎∗, Erin E. Conners, MPH 1, 2, ∗, Kenneth R. McQuaid, MD 1, Sara Epstein, MD 3, James C. Ryan, MD 1, Janak N. Shah, MD 1, John Inadomi, MD 4, Ma Somsouk, MD, MAS 5
1 Department of Medicine, Division of Gastroenterology, San Francisco Veterans Affairs Medical Center and University of California San Francisco, San Francisco, California, USA 
2 Joint Doctoral Program in Public Health, University of California San Diego and San Diego State University, San Diego, California, USA 
3 Department of Medicine, University of California San Francisco, San Francisco, California, USA 
4 Department of Medicine, Division of Gastroenterology and Hepatology, Institution: University of Washington, Seattle, Washington, USA 
5 Department of Medicine, Division of Gastroenterology, San Francisco General Hospital and University of California San Francisco, San Francisco, California, USA 

∗Reprint requests: Amandeep Shergill, MD, MS, 4150 Clement St, San Francisco, CA 94121.

Abstract

Background

The protective effect of colonoscopy against proximal colorectal cancer is variable and depends on the detection and complete removal of precancerous polyps.

Objective

To estimate the efficacy of colonoscopy in a medical center with open-access screening colonoscopy since 1998.

Design

Nested case-control study with incidence density sampling.

Setting

University-affiliated Veterans Affairs Medical Center.

Patients

Colorectal cancer (CRC) cases and control subjects selected from screening age patients matched by age, gender, and date of first primary care visit.

Main Outcome Measurement

Colonoscopy preceding the CRC diagnosis date.

Results

A total of 20.2% of CRC cases had a colonoscopy in the preceding 10 years compared with 49.0% of control subjects (adjusted odds ratio [aOR], 0.20; 95% confidence interval [CI], 0.11-0.34). Colonoscopy was strongly associated with decreased odds of both distal CRC (aOR, 0.16; 95% CI, 0.07-0.34) and proximal CRC (aOR, 0.26; 95% CI, 0.11-0.58). The fraction of cases attributed to interval cancers was 10.5%. Missed lesions predominantly localized to the cecum and rectum, and recurrent lesions clustered in the hepatic flexure. Cecal intubation rate was 93% (98% in adequately prepped patients), and the adenoma detection rate was 45.2% in the control group.

Limitations

Single-center, retrospective case-control design.

Conclusion

In an open access colonoscopy program characterized by a high cecal intubation rate and adenoma detection rate, colonoscopy was strongly associated with reduced odds of both distal and proximal CRC. Among interval cancers, missed lesions clustered in the cecum and rectum and recurrent lesions in the hepatic flexure.

El texto completo de este artículo está disponible en PDF.

Abbreviations : ADR, CPRS, CRC, PCCRC, PCP, SFVAMC, VHA


Esquema


 DISCLOSURE: The following author received research support for this study from the National Institutes of Health (K23 CA157929): M. Somsouk. All authors disclosed no financial relationships relevant to this publication.


© 2015  Publicado por Elsevier Masson SAS.
Añadir a mi biblioteca Eliminar de mi biblioteca Imprimir
Exportación

    Exportación citas

  • Fichero

    •

  • Contenido

    •

Vol 82 - N° 3

P. 529 - septembre 2015 Regresar al número
Artículo precedente Artículo precedente
  • Characterization and significance of protrusions in the mucosal defect after cold snare polypectomy
  • Nicholas Tutticci, Nicholas G. Burgess, Maria Pellise, Duncan Mcleod, Michael J. Bourke
| Artículo siguiente Artículo siguiente
  • Recurrence rates after EMR of large sessile serrated polyps
  • Kevin D. Rex, Krishna C. Vemulapalli, Douglas K. Rex

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.

¿Ya suscrito a @@106933@@ revista ?

Mi cuenta

Aide & support

Declaración CNIL

EM-CONSULTE.COM se declara a la CNIL, la declaración N º 1286925.

En virtud de la Ley N º 78-17 del 6 de enero de 1978, relativa a las computadoras, archivos y libertades, usted tiene el derecho de oposición (art.26 de la ley), el acceso (art.34 a 38 Ley), y correcta (artículo 36 de la ley) los datos que le conciernen. Por lo tanto, usted puede pedir que se corrija, complementado, clarificado, actualizado o suprimido información sobre usted que son inexactos, incompletos, engañosos, obsoletos o cuya recogida o de conservación o uso está prohibido.
La información personal sobre los visitantes de nuestro sitio, incluyendo su identidad, son confidenciales.
El jefe del sitio en el honor se compromete a respetar la confidencialidad de los requisitos legales aplicables en Francia y no de revelar dicha información a terceros.

Todo el contenido en este sitio: Copyright © 2024 Elsevier, sus licenciantes y colaboradores. Se reservan todos los derechos, incluidos los de minería de texto y datos, entrenamiento de IA y tecnologías similares. Para todo el contenido de acceso abierto, se aplican los términos de licencia de Creative Commons.