Rabeneck L, Paszat LF, Saskin R
Endoscopist Specialty is Associated with Incident Colorectal Cancer Following a Negative Colonoscopy. [JOURNAL ARTICLE]
Clin Gastroenterol Hepatol 2009 Oct 29.
BACKGROUND AND AIMS:: The incidence of colorectal cancer (CRC) is reduced for at least 10 years following a negative colonoscopy, compared with the general population. However, CRCs do occur in individuals following a negative colonoscopy. We investigated whether the colonoscopy volume and specialty of the endoscopists who perform the exam are associated with CRC following a negative complete colonoscopy.
METHODS:: A cohort of Ontario residents, 50 to 80 years old, who had a negative complete colonoscopy between January 1, 1992 and December 31, 1997 was identified using linked administrative databases. Cohort members had no prior history of CRC or inflammatory bowel disease or a recent colonic resection. Each individual was followed through December 31, 2006 and those with a new diagnosis of CRC were identified. Multivariable analysis was used to evaluate the association of patient, endoscopist, and procedure setting characteristics with incident CRC.
RESULTS:: A cohort of 110,402 individuals with a negative complete colonoscopy was identified; the majority (86%) had their procedures performed in hospitals. During the 15-year follow-up period, 1,596 (14.5%) developed CRC. There was no association between endoscopist colonoscopy volume and incident CRC. Among persons who had their colonoscopies at a hospital, those who had their procedures performed by a non-gastroenterologist were at significantly increased risk for developing subsequent CRC.
CONCLUSIONS:: Endoscopist specialty is an important determinant of the effectiveness of colonoscopy in usual clinical practice. Following a negative colonoscopy, those who have had their procedures performed by a gastroenterologist are less likely to develop CRC.
More from this journal |
