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Article: Epidemiology, characteristics and survival of post‐colonoscopy colorectal cancer in Asia: a population‐based study
Title | Epidemiology, characteristics and survival of post‐colonoscopy colorectal cancer in Asia: a population‐based study |
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Authors | |
Keywords | adenocarcinoma colon cancer colonoscopy interval cancer rectal cancer |
Issue Date | 2019 |
Publisher | Wiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH |
Citation | Journal of Gastroenterology and Hepatology, 2019, v. 34 n. 9, 1545-1553 How to Cite? |
Abstract | BACKGROUND AND AIMS: Population-based studies on post-colonoscopy colorectal cancer (CRC) from Asia are sparse. We aimed to determine the characteristics and predictive factors and survival of post-colonoscopy CRC in Hong Kong. METHODS: This is a territory-wide retrospective cohort study. Patients aged ≥40 years with colonoscopies performed between 2005 and 2013 without history of CRCs, inflammatory bowel disease and prior colectomy were included. Post-colonoscopy colorectal cancer for an interval of 3 years (PCCRC-3y) was defined as CRC diagnosed between 6 and 36 months after index colonoscopy, whereas CRC diagnosed within 6 months of index colonoscopy was regarded as 'detected CRC'. We used multivariable logistic regression to derive adjusted odds ratio (aOR) of PCCRC-3y, and Cox model for adjusted hazard ratio (aHR) of cancer-specific mortality after CRC diagnosis. RESULTS: Of the 197,902 eligible patients, 10,005 (92.1%) were detected CRC and 854 (7.9%) PCCRC-3y. The median age at PCCRC-3y diagnosis was 75.9 years (IQR: 65.5-83.8) - a delay of 1.2 years (IQR:0.8-1.9) from index colonoscopy, and 60.1% were male. Predictive factors for PCCRC-3y included older age (aOR:1.07), male sex (aOR:1.45), history of colonic polyps (aOR:1.31), polypectomy/biopsy at index colonoscopy (aOR:3.97), surgical endoscopists (aOR:1.53) and a higher center annual endoscopy volume. Independent predictive factors for cancer-specific mortality after CRC diagnosis included PCCRC-3y (aHR:1.32), proximal cancer location (aHR:1.80) and certain patient factors. CONCLUSION: The PCCRC-3y rate was 7.9% in Hong Kong, with a high proportion (>80%) of distal cancers and a higher cancer-specific mortality compared to detected CRC. |
Persistent Identifier | http://hdl.handle.net/10722/269552 |
ISSN | 2023 Impact Factor: 3.7 2023 SCImago Journal Rankings: 1.179 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheung, KSM | - |
dc.contributor.author | Chen, L | - |
dc.contributor.author | Seto, WKW | - |
dc.contributor.author | Leung, WK | - |
dc.date.accessioned | 2019-04-24T08:10:02Z | - |
dc.date.available | 2019-04-24T08:10:02Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | Journal of Gastroenterology and Hepatology, 2019, v. 34 n. 9, 1545-1553 | - |
dc.identifier.issn | 0815-9319 | - |
dc.identifier.uri | http://hdl.handle.net/10722/269552 | - |
dc.description.abstract | BACKGROUND AND AIMS: Population-based studies on post-colonoscopy colorectal cancer (CRC) from Asia are sparse. We aimed to determine the characteristics and predictive factors and survival of post-colonoscopy CRC in Hong Kong. METHODS: This is a territory-wide retrospective cohort study. Patients aged ≥40 years with colonoscopies performed between 2005 and 2013 without history of CRCs, inflammatory bowel disease and prior colectomy were included. Post-colonoscopy colorectal cancer for an interval of 3 years (PCCRC-3y) was defined as CRC diagnosed between 6 and 36 months after index colonoscopy, whereas CRC diagnosed within 6 months of index colonoscopy was regarded as 'detected CRC'. We used multivariable logistic regression to derive adjusted odds ratio (aOR) of PCCRC-3y, and Cox model for adjusted hazard ratio (aHR) of cancer-specific mortality after CRC diagnosis. RESULTS: Of the 197,902 eligible patients, 10,005 (92.1%) were detected CRC and 854 (7.9%) PCCRC-3y. The median age at PCCRC-3y diagnosis was 75.9 years (IQR: 65.5-83.8) - a delay of 1.2 years (IQR:0.8-1.9) from index colonoscopy, and 60.1% were male. Predictive factors for PCCRC-3y included older age (aOR:1.07), male sex (aOR:1.45), history of colonic polyps (aOR:1.31), polypectomy/biopsy at index colonoscopy (aOR:3.97), surgical endoscopists (aOR:1.53) and a higher center annual endoscopy volume. Independent predictive factors for cancer-specific mortality after CRC diagnosis included PCCRC-3y (aHR:1.32), proximal cancer location (aHR:1.80) and certain patient factors. CONCLUSION: The PCCRC-3y rate was 7.9% in Hong Kong, with a high proportion (>80%) of distal cancers and a higher cancer-specific mortality compared to detected CRC. | - |
dc.language | eng | - |
dc.publisher | Wiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH | - |
dc.relation.ispartof | Journal of Gastroenterology and Hepatology | - |
dc.rights | This is the peer reviewed version of the following article: [Journal of Gastroenterology and Hepatology, 2019, v. 34 n. 9, 1545-1553], which has been published in final form at [http://dx.doi.org/10.1111/jgh.14674]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. | - |
dc.subject | adenocarcinoma | - |
dc.subject | colon cancer | - |
dc.subject | colonoscopy | - |
dc.subject | interval cancer | - |
dc.subject | rectal cancer | - |
dc.title | Epidemiology, characteristics and survival of post‐colonoscopy colorectal cancer in Asia: a population‐based study | - |
dc.type | Article | - |
dc.identifier.email | Cheung, KSM: cks634@hku.hk | - |
dc.identifier.email | Chen, L: equalclj@hku.hk | - |
dc.identifier.email | Seto, WKW: wkseto@hku.hk | - |
dc.identifier.email | Leung, WK: waikleung@hku.hk | - |
dc.identifier.authority | Cheung, KSM=rp02532 | - |
dc.identifier.authority | Seto, WKW=rp01659 | - |
dc.identifier.authority | Leung, WK=rp01479 | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1111/jgh.14674 | - |
dc.identifier.scopus | eid_2-s2.0-85066039570 | - |
dc.identifier.hkuros | 297524 | - |
dc.identifier.volume | 34 | - |
dc.identifier.issue | 9 | - |
dc.identifier.spage | 1545 | - |
dc.identifier.epage | 1553 | - |
dc.identifier.isi | WOS:000489071300017 | - |
dc.publisher.place | Australia | - |
dc.identifier.issnl | 0815-9319 | - |