Non-compliance with colonoscopy after a positive faecal immunochemical test doubles the risk of dying from colorectal cancer.

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License: CC BY-NC 4.0
Serval ID
serval:BIB_90AB05A8AD2E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Non-compliance with colonoscopy after a positive faecal immunochemical test doubles the risk of dying from colorectal cancer.
Journal
Gut
Author(s)
Zorzi M., Battagello J., Selby K., Capodaglio G., Baracco S., Rizzato S., Chinellato E., Guzzinati S., Rugge M.
ISSN
1468-3288 (Electronic)
ISSN-L
0017-5749
Publication state
Published
Issued date
03/2022
Peer-reviewed
Oui
Volume
71
Number
3
Pages
561-567
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The risk of colorectal cancer (CRC) among subjects with a positive faecal immunochemical test (FIT) who do not undergo a colonoscopy is unknown. We estimated whether non-compliance with colonoscopy after a positive FIT is associated with increased CRC incidence and mortality.
The FIT-based CRC screening programme in the Veneto region (Italy) invited persons aged 50 to 69 years with a positive FIT (>20 µg Hb/g faeces) for diagnostic colonoscopy at an endoscopic referral centre. In this retrospective cohort study, we compared the 10-year cumulative CRC incidence and mortality among FIT positives who completed a diagnostic colonoscopy within the programme (compliers) and those who did not (non-compliers), using the Kaplan-Meier estimator and Cox-Aalen models.
Some 88 013 patients who were FIT positive complied with colonoscopy (males: 56.1%; aged 50-59 years: 49.1%) while 23 410 did not (males: 54.6%; aged 50-59 years: 44.9%).The 10-year cumulative incidence of CRC was 44.7 per 1000 (95% CI, 43.1 to 46.3) among colonoscopy compliers and 54.3 per 1000 (95% CI, 49.9 to 58.7) in non-compliers, while the cumulative mortality for CRC was 6.8 per 1000 (95% CI, 5.9 to 7.6) and 16.0 per 1000 (95% CI, 13.1 to 18.9), respectively. The risk of dying of CRC among non-compliers was 103% higher than among compliers (adjusted HR, 2.03; 95% CI, 1.68 to 2.44).
The excess risk of CRC death among those not completing colonoscopy after a positive faecal occult blood test should prompt screening programmes to adopt effective interventions to increase compliance in this high-risk population.
Keywords
Aged, Colonoscopy, Colorectal Neoplasms/diagnosis, Colorectal Neoplasms/epidemiology, Early Detection of Cancer, Feces, Female, Humans, Incidence, Italy, Male, Middle Aged, Patient Compliance, Retrospective Studies, Risk Factors, Survival Rate, cancer prevention, colonoscopy, colorectal cancer, colorectal cancer screening
Pubmed
Web of science
Open Access
Yes
Create date
24/04/2021 15:37
Last modification date
12/03/2022 7:29
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