Document Detail


Rate of early/missed colorectal cancers after colonoscopy in older patients with or without inflammatory bowel disease in the United States.
MedLine Citation:
PMID:  23295277     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Patients with inflammatory bowel disease (IBD) have an increased risk for colorectal cancer (CRC). Previous studies on early/missed CRCs after colonoscopy excluded IBD patients. The aim of this study was to compare the rate of early/missed CRCs after colonoscopy among IBD and non-IBD patients, and identify factors associated with early/missed CRCs.
METHODS: All patients in the Surveillance, Epidemiology and End-Results Medicare-linked database who were 67 years or older at colonoscopy during 1998-2005 and those who were subsequently diagnosed with CRC within 36 months were identified. CRCs diagnosed within 6 months of colonoscopy were categorized as detected CRCs; CRCs diagnosed 6-36 months after colonoscopy were categorized as early/missed CRCs. The rate of early/missed CRCs was calculated as number of early/missed CRCs divided by number of detected and early/missed CRCs. The χ(2) test and multivariate logistic regression were used in statistical analysis.
RESULTS: Of 55,008 CRC patients (304 Crohn's disease; 544 ulcerative colitis (UC)), the rate of early/missed CRCs was 5.8% for non-IBD patients, 15.1% for Crohn's, and 15.8% for UC (P<0.001). Compared with older non-IBD patients, early/missed CRCs among older IBD patients were less likely right-sided (both P<0.05). In multivariate logistic regression, the risk of early/missed CRCs was three times as high for IBD patients (Crohn's odds ratio (OR), 3.07; 95% confidence interval (CI) 2.23-4.21; UC OR, 3.05; 95% CI, 2.44-3.81). Sensitivity analyses confirmed the robustness of this finding.
CONCLUSIONS: Older IBD patients had a higher rate of early/missed CRCs after colonoscopy. Our finding supports intensive surveillance colonoscopy for older IBD patients as recommended by guidelines.
Authors:
Yize R Wang; John R Cangemi; Edward V Loftus; Michael F Picco
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2013-01-08
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  108     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-05     Completed Date:  2013-05-20     Revised Date:  2013-10-16    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  444-9     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA. wang-yize@cooperhealth.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Colonoscopy / statistics & numerical data*
Colorectal Neoplasms / diagnosis*,  epidemiology,  etiology
Early Detection of Cancer / statistics & numerical data*
Female
Humans
Inflammatory Bowel Diseases / complications*,  epidemiology
Male
SEER Program
Sensitivity and Specificity
United States / epidemiology
Grant Support
ID/Acronym/Agency:
# U55 / CCR921930-02//PHS HHS; N01-PC-35136/PC/NCI NIH HHS; N01-PC-35139/PC/NCI NIH HHS; N02-PC-15105/PC/NCI NIH HHS
Comments/Corrections
Comment In:
Am J Gastroenterol. 2013 Sep;108(9):1535   [PMID:  24005355 ]
Am J Gastroenterol. 2013 Sep;108(9):1535-6   [PMID:  24005354 ]

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