Single negative colonoscopy linked to reduced colorectal cancer mortality

Current guidelines recommend a 10-year interval between screening colonoscopies, but evidence is limited.

Researchers have found in a new study that having a single negative high-quality screening colonoscopy was associated with reduced colorectal cancer (CRC) incidence and mortality (by 84 percent and 90 percent, respectively) for up to 17.4 years.

These findings suggest that the currently recommended 10-year screening interval could safely be extended. Findings from an observational study are published in Annals of Internal Medicine.

Current guidelines recommend a 10-year interval between negative screening colonoscopies for average-risk adults. This recommendation is based on estimates of time between adenoma and carcinoma, as well as extrapolations from studies assessing colonoscopy sensitivity. A lack of long-term data makes it challenging to determine the optimal screening interval following a normal colonoscopy.

Researchers from The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland studied a screening registry for 165,887 individuals to assess the long-term risk for colorectal cancer and death from colorectal cancer after high- and low-quality single negative screening colonoscopy.

The researchers found that a single negative screening colonoscopy was associated with a significantly reduced CRC incidence and mortality over more than 17 years of follow-up, but only high-quality colonoscopy provided a profound and stable reduction in both colorectal cancer incidence and mortality throughout follow-up period.

High quality was key for the profound long-term efficacy of screening colonoscopy in the proximal colon, and among women. The researchers point out that these findings are of paramount importance, because previous reports have questioned the efficacy of colonoscopy in the proximal colon and of screening sigmoidoscopy in women.

These findings suggest that the currently recommended 10-year interval for screening colonoscopy is safe and could potentially be extended.

For further reference log on to:

https://www.acpjournals.org/doi/10.7326/M19-2477