Screening Interval for Colonoscopic Screening for Colorectal Cancer: A Systematic Review of Interval Cancer Rates of Colonoscopic Screening for Colorectal Cancer

Speaker(s)

Hamashima C1, Abe K1, Terasawa T2, Katayama T3, Hoshi K4, Hosono S5, Sasaki S6, Tadano T7
1Teikyo University, Tokyo, Japan, 2Fujita Health University, Toyoake, Aichi, Japan, 3Hyogo Prefecture University, Akashi, Hyogo, Japan, 4National Institute of Public Health, Wako, Saitama, Japan, 5National Cancer Center, Chuo, Tokyo, Japan, 6St. Luke’s International Hospital, Tokyo, Japan, 7Miyagi Cancer Association, Sendai, Miyagi, Japan

Presentation Documents

OBJECTIVES: Colonoscopy screening has been highly anticipated as a potential primary screening method. The 10-year interval has been recommended in some academic societies, but its scientific evidence needs to be more comprehensive. Interval cancer is defined as a cancer after a negative result of index colonoscopy, and screening interval is dependent on interval cancer rate. We performed a systematic review of interval cancer rates of colonoscopic screening, which was strictly focused on the asymptomatic population.

METHODS: We carried out a literature search using PubMed and Ichushi-Web databases from inception to September 2022. As search terms, “colorectal cancer screening”, “interval cancer”, and “total colonoscopy” were included. The inclusion criteria for the target population were an asymptomatic average-risk population with no polyps or adenomas at index colonoscopy. Advanced neoplasia (AN) was defined as colorectal cancer (CRC) or adenoma of ≥10 mm, with a villous component or high-grade dysplasia. The incidence rates of interval CRC and AN per 100,000 person-years (p-y) were estimated.

RESULTS: From the candidates of 694 articles, 15 articles were identified. Fifteen studies reported interval CRC and AN for 11 studies. For the meta-analysis, 287,602 subjects with negative colonoscopy results were included, whose average follow-up was 7.98 years. Negative colonoscopy results were defined as featuring no adenomas, the incidence rate of interval CRC was 9.57 (95%CI: 2.06-29.94) per 100,000 p-y, and that of AN was 311.5 (95%CI: 153.4-550.7) per 100,000 p-y. Similar results were obtain

CONCLUSIONS: Selected studies were heterogeneous in the target population, follow-up years, and background characteristics. Although interval AN was observed in all studies, the interval cancer rate was low after negative results at index colonoscopy. The screening interval might be defined as long-term, but the actual screening interval could not be recommended because of insufficient results.

Code

EPH153

Topic

Epidemiology & Public Health

Topic Subcategory

Public Health

Disease

Gastrointestinal Disorders, Oncology