Document Detail


Predictors of colorectal cancer following a negative colonoscopy in the Medicare population.
MedLine Citation:
PMID:  21681506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The incidence of colorectal cancer following a normal colonoscopy in the Medicare population is not known.
METHODS: A 5% national sample of Medicare enrollees from 1996 to 2005 was used to identify patients undergoing complete colonoscopy. A colonoscopy not associated with any procedure (e.g., biopsy, polypectomy or fulguration) was defined as a negative colonoscopy. Patients with history of inflammatory bowel disease, colorectal cancer or death within 12 months of colonoscopy were excluded. A multivariable model was constructed to evaluate the factors associated with a new diagnosis of colorectal cancer in the period from 12 to 120 months following the negative colonoscopy.
RESULTS: Among 200,857 patients (mean age 74 years, 61% female, 92% White) with a negative colonoscopy, the incidence of colorectal cancer was 1.8 per 1,000 person-years. The incidence rate for matched follow-up periods decreased from 2.0/1,000 person-years for patients undergoing colonoscopy during 1996-2000 to 1.2/1,000 person years during 2001-2005. Multivariate analysis revealed a significant regional variation in the incidence of colorectal cancer following a negative colonoscopy. The incidence was higher in patients >85 years, males and patients who underwent a negative colonoscopy by a non-gastroenterologist or endoscopist in the lowest volume quartile. On stratified analyses, endoscopist volume was a significant predictor for non-gastroenterologists only.
CONCLUSIONS: The specialty and experience of the endoscopist are significant predictors of the incidence rate of colorectal cancer in Medicare patients with a negative colonoscopy.
Authors:
Amanpal Singh; Yong-Fang Kuo; Taylor S Riall; G S Raju; James S Goodwin
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Publication Detail:
Type:  Journal Article     Date:  2011-06-17
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  56     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-07     Completed Date:  2011-12-27     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3122-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Colonoscopy
Colorectal Neoplasms / diagnosis,  epidemiology*
False Negative Reactions
Female
Humans
Incidence
Male
Medicare
United States
Grant Support
ID/Acronym/Agency:
K05 CA134923/CA/NCI NIH HHS; K05 CA134923-04/CA/NCI NIH HHS; R01 CA134275/CA/NCI NIH HHS; R01 CA134275-04/CA/NCI NIH HHS
Comments/Corrections
Comment In:
Dig Dis Sci. 2011 Oct;56(10):2776-9   [PMID:  21863330 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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