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Colonoscopy Delay After Abnormal FOBT, FIT Ups CRC Risk

WEDNESDAY, Feb. 3, 2021 -- Increased time to colonoscopy after an abnormal fecal occult blood test (FOBT) or fecal immunochemical test (FIT) is associated with an increased risk for colorectal cancer (CRC) incidence and mortality, according to a study published online Feb. 2 in Gastroenterology.

Yazmin San Miguel, M.P.H., from the Veterans Affairs San Diego Healthcare System, and colleagues performed a retrospective cohort study of veterans aged 50 to 75 years with an abnormal FOBT or FIT between 1999 and 2010 to examine the association between the time to colonoscopy and CRC outcomes. CRC-specific incidence and mortality hazard ratios were generated for three-month colonoscopy intervals with one to three months as the reference group.

Data were included for a cohort of 204,733 patients (mean age, 61 years). The researchers found an increased risk for CRC for patients who received a colonoscopy at 13 to 15 months, 16 to 18 months, 19 to 21 months, and 22 to 24 months compared with one to three months (hazard ratios [95 percent confidence intervals], 1.13 [1.00 to 1.27], 1.25 [1.10 to 1.43], 1.28 [1.11 to 1.48], and 1.26 [1.07 to 1.47], respectively). Mortality risk was higher among patients who received a colonoscopy at 19 to 21 months and 22 to 24 months compared with those who received a colonoscopy at one to three months (hazard ratios [95 percent confidence intervals], 1.52 [1.51 to 1.99] and 1.39 [1.03 to 1.88], respectively). At 16 months, the investigators observed an increase in the odds for late-stage CRC.

"Our findings emphasize the importance of colonoscopic follow-up and a need for attention to time to follow-up to avoid excess deaths from CRC during this time of limited access," the authors write.

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Posted: February 2021

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