Five-year risk of colorectal neoplasia after negative screening colonoscopy

Thomas Imperiale, Elizabeth A. Glowinski, Ching Lin-Cooper, Gregory N. Larkin, James D. Rogge, David F. Ransohoff

Research output: Contribution to journalArticle

187 Citations (Scopus)

Abstract

BACKGROUND: The appropriate interval for endoscopic rescreening after a negative colonoscopic examination is uncertain. METHODS: We identified persons with no adenomas on baseline screening colonoscopy who returned at 5 years for follow-up colonoscopy. Findings were categorized according to the most advanced lesion present: no polyp, a hyperplastic polyp, a tubular adenoma less than 1 cm in diameter, an advanced adenoma (a tubular adenoma ≥1 cm in diameter or a polyp with villous histologic features or high-grade dysplasia), or a cancer. RESULTS: Baseline screening colonoscopy had identified 2436 persons with no adenomas; 1256 of them (51.6%) were rescreened a mean (±SD) of 5.34±1.34 years later. The mean age of this group at baseline was 56.7 years; 56.7% of its members were men. No cancers were found on rescreening (95% confidence interval [CI] for the detection rate, 0 to 0.24%). One or more adenomas were found in 201 persons (16.0%). A total of 19 advanced adenomas, of which 10 (52.6%) were distal to the splenic flexure, were found in 16 persons (1.3%). The risk of an advanced adenoma did not differ significantly between persons with no polyps at baseline and those with hyperplastic polyps at baseline (1.1% [12 of 1057] and 2.0% [4 of 199], respectively; P=0.30). Men were more likely than women to have any adenoma (tubular less than 1 cm in diameter or advanced) (relative risk, 1.88; 95% CI, 1.42 to 2.51) and to have an advanced adenoma (relative risk, 3.31; 95% CI, 1.02 to 10.8). CONCLUSIONS: Among persons with no colorectal neoplasia on initial screening colonoscopy, the 5-year risk of colorectal cancer is extremely low. The risk of advanced adenoma is also low, although it is higher among men than among women. Our findings support a rescreening interval of 5 years or longer after a normal colonoscopic examination.

Original languageEnglish
Pages (from-to)1218-1224
Number of pages7
JournalNew England Journal of Medicine
Volume359
Issue number12
DOIs
StatePublished - Sep 18 2008

Fingerprint

Colonoscopy
Adenoma
Polyps
Neoplasms
Confidence Intervals
Transverse Colon
Colorectal Neoplasms
Age Groups

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Imperiale, T., Glowinski, E. A., Lin-Cooper, C., Larkin, G. N., Rogge, J. D., & Ransohoff, D. F. (2008). Five-year risk of colorectal neoplasia after negative screening colonoscopy. New England Journal of Medicine, 359(12), 1218-1224. https://doi.org/10.1056/NEJMoa0803597

Five-year risk of colorectal neoplasia after negative screening colonoscopy. / Imperiale, Thomas; Glowinski, Elizabeth A.; Lin-Cooper, Ching; Larkin, Gregory N.; Rogge, James D.; Ransohoff, David F.

In: New England Journal of Medicine, Vol. 359, No. 12, 18.09.2008, p. 1218-1224.

Research output: Contribution to journalArticle

Imperiale, T, Glowinski, EA, Lin-Cooper, C, Larkin, GN, Rogge, JD & Ransohoff, DF 2008, 'Five-year risk of colorectal neoplasia after negative screening colonoscopy', New England Journal of Medicine, vol. 359, no. 12, pp. 1218-1224. https://doi.org/10.1056/NEJMoa0803597
Imperiale, Thomas ; Glowinski, Elizabeth A. ; Lin-Cooper, Ching ; Larkin, Gregory N. ; Rogge, James D. ; Ransohoff, David F. / Five-year risk of colorectal neoplasia after negative screening colonoscopy. In: New England Journal of Medicine. 2008 ; Vol. 359, No. 12. pp. 1218-1224.
@article{a7dc11948b354c918ecdcf037e777554,
title = "Five-year risk of colorectal neoplasia after negative screening colonoscopy",
abstract = "BACKGROUND: The appropriate interval for endoscopic rescreening after a negative colonoscopic examination is uncertain. METHODS: We identified persons with no adenomas on baseline screening colonoscopy who returned at 5 years for follow-up colonoscopy. Findings were categorized according to the most advanced lesion present: no polyp, a hyperplastic polyp, a tubular adenoma less than 1 cm in diameter, an advanced adenoma (a tubular adenoma ≥1 cm in diameter or a polyp with villous histologic features or high-grade dysplasia), or a cancer. RESULTS: Baseline screening colonoscopy had identified 2436 persons with no adenomas; 1256 of them (51.6{\%}) were rescreened a mean (±SD) of 5.34±1.34 years later. The mean age of this group at baseline was 56.7 years; 56.7{\%} of its members were men. No cancers were found on rescreening (95{\%} confidence interval [CI] for the detection rate, 0 to 0.24{\%}). One or more adenomas were found in 201 persons (16.0{\%}). A total of 19 advanced adenomas, of which 10 (52.6{\%}) were distal to the splenic flexure, were found in 16 persons (1.3{\%}). The risk of an advanced adenoma did not differ significantly between persons with no polyps at baseline and those with hyperplastic polyps at baseline (1.1{\%} [12 of 1057] and 2.0{\%} [4 of 199], respectively; P=0.30). Men were more likely than women to have any adenoma (tubular less than 1 cm in diameter or advanced) (relative risk, 1.88; 95{\%} CI, 1.42 to 2.51) and to have an advanced adenoma (relative risk, 3.31; 95{\%} CI, 1.02 to 10.8). CONCLUSIONS: Among persons with no colorectal neoplasia on initial screening colonoscopy, the 5-year risk of colorectal cancer is extremely low. The risk of advanced adenoma is also low, although it is higher among men than among women. Our findings support a rescreening interval of 5 years or longer after a normal colonoscopic examination.",
author = "Thomas Imperiale and Glowinski, {Elizabeth A.} and Ching Lin-Cooper and Larkin, {Gregory N.} and Rogge, {James D.} and Ransohoff, {David F.}",
year = "2008",
month = "9",
day = "18",
doi = "10.1056/NEJMoa0803597",
language = "English",
volume = "359",
pages = "1218--1224",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "12",

}

TY - JOUR

T1 - Five-year risk of colorectal neoplasia after negative screening colonoscopy

AU - Imperiale, Thomas

AU - Glowinski, Elizabeth A.

AU - Lin-Cooper, Ching

AU - Larkin, Gregory N.

AU - Rogge, James D.

AU - Ransohoff, David F.

PY - 2008/9/18

Y1 - 2008/9/18

N2 - BACKGROUND: The appropriate interval for endoscopic rescreening after a negative colonoscopic examination is uncertain. METHODS: We identified persons with no adenomas on baseline screening colonoscopy who returned at 5 years for follow-up colonoscopy. Findings were categorized according to the most advanced lesion present: no polyp, a hyperplastic polyp, a tubular adenoma less than 1 cm in diameter, an advanced adenoma (a tubular adenoma ≥1 cm in diameter or a polyp with villous histologic features or high-grade dysplasia), or a cancer. RESULTS: Baseline screening colonoscopy had identified 2436 persons with no adenomas; 1256 of them (51.6%) were rescreened a mean (±SD) of 5.34±1.34 years later. The mean age of this group at baseline was 56.7 years; 56.7% of its members were men. No cancers were found on rescreening (95% confidence interval [CI] for the detection rate, 0 to 0.24%). One or more adenomas were found in 201 persons (16.0%). A total of 19 advanced adenomas, of which 10 (52.6%) were distal to the splenic flexure, were found in 16 persons (1.3%). The risk of an advanced adenoma did not differ significantly between persons with no polyps at baseline and those with hyperplastic polyps at baseline (1.1% [12 of 1057] and 2.0% [4 of 199], respectively; P=0.30). Men were more likely than women to have any adenoma (tubular less than 1 cm in diameter or advanced) (relative risk, 1.88; 95% CI, 1.42 to 2.51) and to have an advanced adenoma (relative risk, 3.31; 95% CI, 1.02 to 10.8). CONCLUSIONS: Among persons with no colorectal neoplasia on initial screening colonoscopy, the 5-year risk of colorectal cancer is extremely low. The risk of advanced adenoma is also low, although it is higher among men than among women. Our findings support a rescreening interval of 5 years or longer after a normal colonoscopic examination.

AB - BACKGROUND: The appropriate interval for endoscopic rescreening after a negative colonoscopic examination is uncertain. METHODS: We identified persons with no adenomas on baseline screening colonoscopy who returned at 5 years for follow-up colonoscopy. Findings were categorized according to the most advanced lesion present: no polyp, a hyperplastic polyp, a tubular adenoma less than 1 cm in diameter, an advanced adenoma (a tubular adenoma ≥1 cm in diameter or a polyp with villous histologic features or high-grade dysplasia), or a cancer. RESULTS: Baseline screening colonoscopy had identified 2436 persons with no adenomas; 1256 of them (51.6%) were rescreened a mean (±SD) of 5.34±1.34 years later. The mean age of this group at baseline was 56.7 years; 56.7% of its members were men. No cancers were found on rescreening (95% confidence interval [CI] for the detection rate, 0 to 0.24%). One or more adenomas were found in 201 persons (16.0%). A total of 19 advanced adenomas, of which 10 (52.6%) were distal to the splenic flexure, were found in 16 persons (1.3%). The risk of an advanced adenoma did not differ significantly between persons with no polyps at baseline and those with hyperplastic polyps at baseline (1.1% [12 of 1057] and 2.0% [4 of 199], respectively; P=0.30). Men were more likely than women to have any adenoma (tubular less than 1 cm in diameter or advanced) (relative risk, 1.88; 95% CI, 1.42 to 2.51) and to have an advanced adenoma (relative risk, 3.31; 95% CI, 1.02 to 10.8). CONCLUSIONS: Among persons with no colorectal neoplasia on initial screening colonoscopy, the 5-year risk of colorectal cancer is extremely low. The risk of advanced adenoma is also low, although it is higher among men than among women. Our findings support a rescreening interval of 5 years or longer after a normal colonoscopic examination.

UR - http://www.scopus.com/inward/record.url?scp=52249089796&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=52249089796&partnerID=8YFLogxK

U2 - 10.1056/NEJMoa0803597

DO - 10.1056/NEJMoa0803597

M3 - Article

VL - 359

SP - 1218

EP - 1224

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 12

ER -