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Inicio Medicina Clínica (English Edition) Post-colonoscopy colorectal cancer: Characteristics and predictive factors
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Vol. 150. Issue 1.
Pages 1-7 (January 2018)
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Vol. 150. Issue 1.
Pages 1-7 (January 2018)
Original article
Post-colonoscopy colorectal cancer: Characteristics and predictive factors
Cáncer colorrectal poscolonoscopia: características y factores predictivos
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María Muñoz García-Borruela, Antonio José Hervás Molinaa,
Corresponding author
ahervasm@telefonica.net

Corresponding author.
, Manuel L. Rodríguez Perálvareza, Estefanía Moreno Rincóna, Indhira Pérez Medranoa, Francisco Javier Serrano Ruiza, Luis Leonardo Casáis Juanenaa, María Pleguezuelo Navarroa, Antonio Naranjo Rodrígueza, Carlos Villar Pastorb
a Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, Spain
b Unidad de Gestión Clínica de Anatomía Patológica, Hospital Universitario Reina Sofía, Córdoba, Spain
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Tables (4)
Table 1. Incidence of colorectal cancer by years.
Table 2. Comparative analysis of patients with colorectal cancer without previous colonoscopy and patients with colorectal cancer with previous colonoscopy.
Table 3. Characteristics of the previous colonoscopy and other colonoscopies in the 10 years before the diagnosis of colorectal cancer in the group of patients with post-colonoscopy colorectal cancer.
Table 4. Independent risk factors related to the occurrence of post-colonoscopy colorectal cancer. Multivariate analysis.
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Abstract
Introduction and aims

A high quality colonoscopy is key in preventing colorectal cancer, but the risk of colorectal cancer (CRC) exists. The aims of the study were to investigate the incidence, characteristics and predictive factors of post-colonoscopy colorectal cancer (PCCRC).

Material and method

A retrospective and prospective observational study was designed. A population undergoing colonoscopy between 1-01-1997 and 31-12-2014 was included. We analyzed demographic variables, characteristics of the diagnostic colonoscopy of CRC, of the previous ones and the lesions found in them. To compare the PCCRC group versus the CRC group without previous colonoscopy, the Student's t-test and multiple logistic regression were used to determine predictive factors of PCCRC (SPSS® 15). The statistical significance was p<0.05.

Results

A total of 56,984 colonoscopies, 1977 CRC and 132 patients (mean 70.8 years old, 56.8% male) with at least one colonoscopy in 10 years before were registered (PCCRC). Seventy and a half percent of the previous colonoscopies were completed and 63.7% had an adequate bowel preparation. Predictive factors of PCCRC were personal history of polyps (OR 35.01; 95% CI 11.1–110.8; p<0.001), previous CRC (OR 176.64; 95% CI 51.5–606.1); p<0.001), family history of CRC (OR 3.14; 95% CI 1.5–6.4); p=0.002) and proximal CRC (OR 3.15; 95% CI 2.1–4.9; p<0.001).

Conclusions

PCCRC rate in 10 years was 6.7%. An adequate follow-up and a high-quality colonoscopy could prevent PCCRC, especially in patients with risk factors.

Keywords:
Colorectal cancer
Post-colonoscopy colorectal cancer
Interval cancer
Colonoscopy
Screening
Resumen
Introducción y objetivos

La calidad de la colonoscopia es clave para asegurar la prevención del adenocarcinoma colorrectal (ACCR), aunque el riesgo de ACCR existe. Los objetivos del estudio fueron investigar la incidencia, las características y los factores predictores de ACCR poscolonoscopia (ACCRPC).

Material y método

Estudio observacional retrospectivo y prospectivo sobre una población sometida a colonoscopia entre 1-01-1997 y 31-12-2014. Se analizaron variables demográficas, características de la colonoscopia diagnóstica de ACCR, de las previas y de las lesiones encontradas en ellas. Se aplicaron test de contraste de hipótesis para comparar el grupo de ACCRPC con el de ACCR sin colonoscopia previa y regresión logística múltiple para identificar factores independientes de ACCRPC (SPSS® 15), considerando significación estadística una p<0,05.

Resultados

Se registraron 56.984 colonoscopias, 1.977 ACCR y 132 pacientes (edad media de 70,8 años y 56,8% varones) con al menos una colonoscopia en los 10 años previos (ACCRPC). El 70,5% de las colonoscopias previas fueron completas y el 63,7% tenían una preparación adecuada. Los factores de riesgo independientes relacionados con la aparición de ACCRPC fueron los antecedentes personales de pólipos colónicos (OR 35,01; IC 95% 11,1-110,8; p<0,001), antecedentes personales de ACCR (OR 176,64; IC 95% 51,5-606,1); p<0,001), antecedentes familiares de ACCR (OR 3,14; IC 95% 1,5–6,4); p=0,002) y la localización del ACCR en el colon derecho (OR 3,15; IC 95% 2,1–4,9; p<0,001).

Conclusiones

La tasa de ACCRPC a 10 años fue del 6,7%. Realizar un adecuado seguimiento y una colonoscopia de calidad puede evitar la aparición del ACCRPC, especialmente en los pacientes con factores de riesgo.

Palabras clave:
Adenocarcinoma colorrectal
Cáncer poscolonoscopia
Cáncer de intervalo
Colonoscopia
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