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dc.contributor.authorRen J
dc.contributor.authorKirkness CS
dc.contributor.authorKim M
dc.contributor.authorAsche CV
dc.contributor.authorPuli S
dc.date.accessioned2016-12-08T17:51:30Z
dc.date.available2017-04-09T09:30:06Z
dc.date.issued2016-04
dc.identifier.bibliographicCitationRen, J. M., Kirkness, C. S., Kim, M., Asche, C. V. and Puli, S. Long-term risk of colorectal cancer by gender after positive colonoscopy: population-based cohort study. Current Medical Research and Opinion. 2016. 32(8): 1367-1374. doi: 10.1080/03007995.2016.1174840.en_US
dc.identifier.issn0300-7995
dc.identifier.urihttp://hdl.handle.net/10027/21375
dc.descriptionPost print version of article may differ from published version. This is an electronic version of an article published in Ren, J. M., Kirkness, C. S., Kim, M., Asche, C. V. and Puli, S. Long-term risk of colorectal cancer by gender after positive colonoscopy: population-based cohort study. Current Medical Research and Opinion. 2016. 32(8): 1367-1374. DOI: 10.1080/03007995.2016.1174840. Current Medical Research and Opinion is available online at: http://www.informaworld.com/smpp/ DOI: 10.1080/03007995.2016.1174840.en_US
dc.description.abstractBackground: Evidence for surveillance intervals of colonoscopy are primarily based on adenoma recur-rence rate rather than on colorectal cancer (C.R.C.) incidence. Little is known about long-term risk of C.R.C. after positive colonoscopy. In view of men have significantly higher C.R.C. risk than women, we aimed to estimate the gender-specific C.R.C. incidence after positive colonoscopy (adenoma or malig-nant lesion) at follow-up colonoscopy. Methods: A retrospective cohort study was conducted using data from a database of colonoscopy screening and surveillance. Patients having had a colonoscopy (January 2010–March 2014) were selected as study subjects and the history of prior colonoscopies was reviewed. Multivariable Weibull regression models were used to estimate the incidence of C.R.C. at follow-up colonoscopy for subjects who were assigned a stratified risk level. The benchmark risk was defined according to a national survey. Results: The interval incidence of C.R.C. at a 10 year follow-up was 164 (95% C.I. 63–343) and 79 (95%C.I. 26–188) per 100,000 person-years for low-risk men and women respectively, which tallied with our benchmark risk. Men exceeded the benchmark risk in 3–5 years if they had an incomplete polyp removal, 􀀀3 adenomas during their last colonoscopy or a personal C.R.C. history, and in 7–8 years if they only had familial C.R.C. history. Women had a lower risk of C.R.C., and reached a same risk level 3–5 years later than men. Coexisting above risk factors resulted in a sharp increase in the incidence of C.R.C. at follow-up exceeding the benchmark much earlier. Conclusion: Surveillance intervals for men based on incidence of C.R.C. are in line with that recom-mended by the current guidelines for colonoscopy. However, an extension of 3–5 years may be appro-priate for women. To target personalized medicine, a risk predictive model could be used to identify an appropriate surveillance interval for each individual in the future.Background: Evidence for surveillance intervals of colonoscopy are primarily based on adenoma recur-rence rate rather than on colorectal cancer (C.R.C.) incidence. Little is known about long-term risk of C.R.C. after positive colonoscopy. In view of men have significantly higher C.R.C. risk than women, we aimed to estimate the gender-specific C.R.C. incidence after positive colonoscopy (adenoma or malig-nant lesion) at follow-up colonoscopy. Methods: A retrospective cohort study was conducted using data from a database of colonoscopy screening and surveillance. Patients having had a colonoscopy (January 2010–March 2014) were selected as study subjects and the history of prior colonoscopies was reviewed. Multivariable Weibull regression models were used to estimate the incidence of C.R.C. at follow-up colonoscopy for subjects who were assigned a stratified risk level. The benchmark risk was defined according to a national survey. Results: The interval incidence of C.R.C. at a 10 year follow-up was 164 (95% C.I. 63–343) and 79 (95%C.I. 26–188) per 100,000 person-years for low-risk men and women respectively, which tallied with our benchmark risk. Men exceeded the benchmark risk in 3–5 years if they had an incomplete polyp removal, 􀀀3 adenomas during their last colonoscopy or a personal C.R.C. history, and in 7–8 years if they only had familial C.R.C. history. Women had a lower risk of C.R.C., and reached a same risk level 3–5 years later than men. Coexisting above risk factors resulted in a sharp increase in the incidence of C.R.C. at follow-up exceeding the benchmark much earlier. Conclusion: Surveillance intervals for men based on incidence of C.R.C. are in line with that recom-mended by the current guidelines for colonoscopy. However, an extension of 3–5 years may be appro-priate for women. To target personalized medicine, a risk predictive model could be used to identify an appropriate surveillance interval for each individual in the future.en_US
dc.language.isoen_USen_US
dc.publisherTaylor & Francisen_US
dc.subjectCohort studyen_US
dc.subjectColonoscopyen_US
dc.subjectIncidenceen_US
dc.subjectScreeningen_US
dc.titleLong-term risk of colorectal cancer by gender after positive colonoscopy: population-based cohort study.en_US
dc.typeArticleen_US


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