Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening
Objectives: Fecal immunochemical testing (FIT) and colonoscopy are tandem procedures in colorectal cancer (CRC) screening. A positive FIT predicts advanced neoplasia (AN) that requires endoscopic detection and removal. En bloc or piecemeal resection of AN is associated with a significant rate of res...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
| Published: |
Nature Publishing Group
2015
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| Online Access: | http://hdl.handle.net/20.500.11937/49874 |
| _version_ | 1848758337922924544 |
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| author | Grobbee, E. Kapidzic, A. van Vuuren, A. van Leerdam, M. Lansdorp-Vogelaar, Iris Looman, C. Bruno, M. Kuipers, E. Spaander, M. |
| author_facet | Grobbee, E. Kapidzic, A. van Vuuren, A. van Leerdam, M. Lansdorp-Vogelaar, Iris Looman, C. Bruno, M. Kuipers, E. Spaander, M. |
| author_sort | Grobbee, E. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objectives: Fecal immunochemical testing (FIT) and colonoscopy are tandem procedures in colorectal cancer (CRC) screening. A positive FIT predicts advanced neoplasia (AN) that requires endoscopic detection and removal. En bloc or piecemeal resection of AN is associated with a significant rate of residual or recurrent neoplasia. Second-look colonoscopies are indicated to assess completeness of removal of AN. These colonoscopies can make a substantial demand on colonoscopy capacity and health-care system. This study is the first to evaluate the demand and risk factors for second-look colonoscopy in FIT CRC screening. Methods: All colonoscopies after a positive FIT, in subjects aged 50–74 years approached for 3 rounds of FIT screening, were prospectively registered. Second-look colonoscopies were defined as any colonoscopy within 1 year following a colonoscopy after positive FIT. Results: Out of 1,215 FIT-positive screenees undergoing colonoscopy, 105 (8.6%) patients underwent a second-look colonoscopy, of whom 30 (2.5%) underwent more than one colonoscopy (range 2–9), leading to a total of 149 (12.3%) additional colonoscopies. Main reasons for second-look colonoscopies were assessment of complete AN removal (41.9%) and need for additional polypectomy (34.3%). Risk factors were advanced adenomas and poor bowel preparation (P<0.001). High fecal hemoglobin concentration was the only predictor of a second-look colonoscopy before index colonoscopy (P<0.001). Conclusions: Second-look colonoscopies have substantial impact on colonoscopy resources, increasing the demand with 12%. The main reasons for these second-look colonoscopies were previous incomplete polypectomy and control of completeness of removal of neoplastic lesions. A high fecal hemoglobin concentration as measured by FIT can help to identify patients at risk of a second-look colonoscopy. |
| first_indexed | 2025-11-14T09:42:24Z |
| format | Journal Article |
| id | curtin-20.500.11937-49874 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:42:24Z |
| publishDate | 2015 |
| publisher | Nature Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-498742018-04-09T03:50:25Z Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening Grobbee, E. Kapidzic, A. van Vuuren, A. van Leerdam, M. Lansdorp-Vogelaar, Iris Looman, C. Bruno, M. Kuipers, E. Spaander, M. Objectives: Fecal immunochemical testing (FIT) and colonoscopy are tandem procedures in colorectal cancer (CRC) screening. A positive FIT predicts advanced neoplasia (AN) that requires endoscopic detection and removal. En bloc or piecemeal resection of AN is associated with a significant rate of residual or recurrent neoplasia. Second-look colonoscopies are indicated to assess completeness of removal of AN. These colonoscopies can make a substantial demand on colonoscopy capacity and health-care system. This study is the first to evaluate the demand and risk factors for second-look colonoscopy in FIT CRC screening. Methods: All colonoscopies after a positive FIT, in subjects aged 50–74 years approached for 3 rounds of FIT screening, were prospectively registered. Second-look colonoscopies were defined as any colonoscopy within 1 year following a colonoscopy after positive FIT. Results: Out of 1,215 FIT-positive screenees undergoing colonoscopy, 105 (8.6%) patients underwent a second-look colonoscopy, of whom 30 (2.5%) underwent more than one colonoscopy (range 2–9), leading to a total of 149 (12.3%) additional colonoscopies. Main reasons for second-look colonoscopies were assessment of complete AN removal (41.9%) and need for additional polypectomy (34.3%). Risk factors were advanced adenomas and poor bowel preparation (P<0.001). High fecal hemoglobin concentration was the only predictor of a second-look colonoscopy before index colonoscopy (P<0.001). Conclusions: Second-look colonoscopies have substantial impact on colonoscopy resources, increasing the demand with 12%. The main reasons for these second-look colonoscopies were previous incomplete polypectomy and control of completeness of removal of neoplastic lesions. A high fecal hemoglobin concentration as measured by FIT can help to identify patients at risk of a second-look colonoscopy. 2015 Journal Article http://hdl.handle.net/20.500.11937/49874 10.1038/ajg.2015.157 Nature Publishing Group restricted |
| spellingShingle | Grobbee, E. Kapidzic, A. van Vuuren, A. van Leerdam, M. Lansdorp-Vogelaar, Iris Looman, C. Bruno, M. Kuipers, E. Spaander, M. Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening |
| title | Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening |
| title_full | Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening |
| title_fullStr | Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening |
| title_full_unstemmed | Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening |
| title_short | Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening |
| title_sort | second-look colonoscopies and the impact on capacity in fit-based colorectal cancer screening |
| url | http://hdl.handle.net/20.500.11937/49874 |