PMID- 29317271
OWN - NLM
STAT- MEDLINE
DCOM- 20181106
LR  - 20181106
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 87
IP  - 5
DP  - 2018 May
TI  - Temporal trends in postcolonoscopy colorectal cancer rates in 50- to 74-year-old 
      persons: a population-based study.
PG  - 1324-1334.e4
LID - S0016-5107(18)30014-2 [pii]
LID - 10.1016/j.gie.2017.12.027 [doi]
AB  - BACKGROUND AND AIMS: Colorectal cancers (CRCs) diagnosed between 6 and 36 months 
      after colonoscopy, termed postcolonoscopy CRCs (PCCRCs), arise primarily due to
      missed or inadequately treated neoplasms during colonoscopy. Introduction of
      multiple quality indicators and technological advances to colonoscopy practice
      should have reduced the PCCRC rate over time. We assessed temporal trends in the 
      population rate of PCCRC as a measure of changing colonoscopy quality. METHODS:
      We conducted a population-based retrospective cohort study of persons aged 50 to 
      74 years without advanced risk factors for CRC who underwent complete colonoscopy
      in Ontario, Canada between 1996 and 2010. We defined the PCCRC rate as the
      proportion of individuals diagnosed with CRC within 36 months of colonoscopy that
      had PCCRC. We compared age-adjusted and sex-adjusted rates of PCCRC over time
      based on 3 periods (1996-2001, 2001-2006 and 2006-2010) and assessed the
      independent association between time period and PCCRC risk through multivariable 
      regression, with respect to all PCCRCs, proximal PCCRC and distal PCCRC. RESULTS:
      There was a marked increase in colonoscopy volumes over the study period,
      particularly in younger age groups and non-hospital settings. Among 1,093,658
      eligible persons the PCCRC rate remained stable at approximately 8% over the
      15-year study period. The adjusted odds of PCCRC, distal PCCRC and proximal
      PCCRC, comparing the 2006 to 2010 period with the 1996 to 2001 period, were 1.14 
      (95% confidence interval [CI], 1.0-1.31), 1.11 (95% CI, 0.91-1.34), and 1.14 (95%
      CI, 0.94-1.38), respectively. Temporal trends in PCCRC risk did not differ by
      endoscopist specialty or institutional setting after covariate adjustment.
      CONCLUSION: The PCCRC rate in Ontario has remained consistently high over time.
      Widespread initiatives are needed to improve colonoscopy quality.
CI  - Copyright (c) 2018 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Murthy, Sanjay K
AU  - Murthy SK
AD  - Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa
      Hospital Research Institute, Ottawa, Ontario, Canada; Institute for Clinical
      Evaluative Sciences (Toronto) and ICES uOttawa, Ontario, Canada.
FAU - Benchimol, Eric I
AU  - Benchimol EI
AD  - Institute for Clinical Evaluative Sciences (Toronto) and ICES uOttawa, Ontario,
      Canada; Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; 
      Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa,
      Ontario, Canada.
FAU - Tinmouth, Jill
AU  - Tinmouth J
AD  - Institute for Clinical Evaluative Sciences (Toronto) and ICES uOttawa, Ontario,
      Canada; Department of Medicine, Sunnybrook Health Sciences Centre, Toronto,
      Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada.
FAU - James, Paul D
AU  - James PD
AD  - Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa
      Hospital Research Institute, Ottawa, Ontario, Canada.
FAU - Ducharme, Robin
AU  - Ducharme R
AD  - Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Institute for
      Clinical Evaluative Sciences (Toronto) and ICES uOttawa, Ontario, Canada.
FAU - Rostom, Alaa
AU  - Rostom A
AD  - Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa
      Hospital Research Institute, Ottawa, Ontario, Canada.
FAU - Dube, Catherine
AU  - Dube C
AD  - Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa
      Hospital Research Institute, Ottawa, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20180106
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Adenoma/*diagnosis
MH  - Aged
MH  - Cohort Studies
MH  - Colonic Polyps/*diagnosis
MH  - *Colonoscopy
MH  - Colorectal Neoplasms/diagnosis/*epidemiology
MH  - Early Detection of Cancer
MH  - Humans
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Ontario/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
EDAT- 2018/01/11 06:00
MHDA- 2018/11/07 06:00
CRDT- 2018/01/11 06:00
PHST- 2017/07/20 00:00 [received]
PHST- 2017/12/10 00:00 [accepted]
PHST- 2018/01/11 06:00 [pubmed]
PHST- 2018/11/07 06:00 [medline]
PHST- 2018/01/11 06:00 [entrez]
AID - S0016-5107(18)30014-2 [pii]
AID - 10.1016/j.gie.2017.12.027 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2018 May;87(5):1324-1334.e4. doi: 10.1016/j.gie.2017.12.027.
      Epub 2018 Jan 6.