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@ARTICLE{Liang:289950,
author = {Q. Liang$^*$ and T. Mukama$^*$ and K. Sundquist and J.
Sundquist and H. Brenner$^*$ and E. Kharazmi$^*$ and M.
Fallah$^*$},
title = {{L}onger {I}nterval {B}etween {F}irst {C}olonoscopy {W}ith
{N}egative {F}indings for {C}olorectal {C}ancer and {R}epeat
{C}olonoscopy.},
journal = {JAMA oncology},
volume = {10},
number = {7},
issn = {2374-2437},
address = {Chicago, Ill.},
publisher = {American Medical Association},
reportid = {DKFZ-2024-00932},
pages = {866-873},
year = {2024},
note = {#EA:C120#LA:C120# / 2024 Jul 1;10(7):866-873},
abstract = {For individuals without a family history of colorectal
cancer (CRC), colonoscopy screening every 10 years is
recommended to reduce CRC incidence and mortality. However,
debate exists about whether and for how long this 10-year
interval could be safely expanded.To assess how many years
after a first colonoscopy with findings negative for CRC a
second colonoscopy can be performed.This cohort study
leveraged Swedish nationwide register-based data to examine
CRC diagnoses and CRC-specific mortality among individuals
without a family history of CRC. The exposed group included
individuals who had a first colonoscopy with findings
negative for CRC at age 45 to 69 years between 1990 and
2016. The control group included individuals matched by sex,
birth year, and baseline age (ie, the age of their matched
exposed individual when the exposed individual's first
colonoscopy with findings negative for CRC was performed).
Individuals in the control group either did not have a
colonoscopy during the follow-up or underwent colonoscopy
that resulted in a CRC diagnosis. Up to 18 controls were
matched with each exposed individual. Individuals were
followed up from 1990 to 2018, and data were analyzed from
November 2022 to November 2023.A first colonoscopy with
findings negative for CRC, defined as a first colonoscopy
without a diagnosis of colorectal polyp, adenoma, carcinoma
in situ, or CRC before or within 6 months after
screening.The primary outcomes were CRC diagnosis and
CRC-specific death. The 10-year standardized incidence ratio
and standardized mortality ratio were calculated to compare
risks of CRC and CRC-specific death in the exposed and
control groups based on different follow-up screening
intervals.The sample included 110 074 individuals (65 147
females $[59.2\%])$ in the exposed group and 1 981 332 (1
172 646 females $[59.2\%])$ in the control group. The median
(IQR) age for individuals in both groups was 59 (52-64)
years. During up to 29 years of follow-up of individuals
with a first colonoscopy with findings negative for CRC, 484
incident CRCs and 112 CRC-specific deaths occurred. After a
first colonoscopy with findings negative for CRC, the risks
of CRC and CRC-specific death in the exposed group were
significantly lower than those in their matched controls for
15 years. At 15 years after a first colonoscopy with
findings negative for CRC, the 10-year standardized
incidence ratio was 0.72 $(95\%$ CI, 0.54-0.94) and the
10-year standardized mortality ratio was 0.55 $(95\%$ CI,
0.29-0.94). In other words, the 10-year cumulative risk of
CRC in year 15 in the exposed group was $72\%$ that of the
10-year cumulative risk of CRC in the control group.
Extending the colonoscopy screening interval from 10 to 15
years in individuals with a first colonoscopy with findings
negative for CRC could miss the early detection of only 2
CRC cases and the prevention of 1 CRC-specific death per
1000 individuals, while potentially avoiding 1000
colonoscopies.This cohort study found that for the
population without a family history of CRC, the 10-year
interval between colonoscopy screenings for individuals with
a first colonoscopy with findings negative for CRC could
potentially be extended to 15 years. A longer interval
between colonoscopy screenings could be beneficial in
avoiding unnecessary invasive examinations.},
cin = {C120 / C070 / HD01},
ddc = {610},
cid = {I:(DE-He78)C120-20160331 / I:(DE-He78)C070-20160331 /
I:(DE-He78)HD01-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:38696176},
doi = {10.1001/jamaoncol.2024.0827},
url = {https://inrepo02.dkfz.de/record/289950},
}