Advanced Adenoma Findings at Screening Colonoscopy Associated With Noncolorectal Cancer Mortality
Douglas K. Rex, MD, MASGE, reviewing Sullivan BA, et al. Clin Transl Gastroenterol 2022 Mar 25.
This study used the VA Cooperative Screening Colonoscopy Study, one of the pivotal trials that led to federal legislation directing the Centers for Medicare and Medicaid Services to pay for screening colonoscopy. There were 3121 colonoscopy screenees, of whom 97% were male and 84% were White individuals. During 10 years of follow-up, 858 died, including 843 from noncolorectal cancer causes and 15 from colorectal cancer (CRC). Non-CRC mortality was associated with African American race (hazard ratio [HR], 1.26), increasing age (HR, 1.07 per year), 3 to 4 comorbidities at baseline (HR, 1.57), and current smokers (HR, 2.12). Non-CRC mortality was increased (after adjustment for other factors) in patients with ≥3 small adenomas (HR, 1.43), advanced adenomas (HR, 1.32), and CRC (HR, 2.95). The increased risk was not statistically significant in those with 1 to 2 small adenomas at baseline (HR, 1.15; confidence interval, 0.94-1.4).
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Sullivan BA, Qin X, Miller C, et al. Screening colonoscopy findings are associated with noncolorectal cancer mortality. Clin Transl Gastroenterol 2022 Mar 25. (Epub ahead of print) (https://doi.org/10.14309/ctg.0000000000000479)