In a study reported in JAMA Oncology, Knudsen et al found evidence supporting the consideration of extending the rescreening intervals after a negative colonoscopy screening result beyond the currently recommended 10 years, particularly among individuals with a low-risk profile.
Study Details
The U.S. cohort study involved data from three prospective U.S. population–based cohorts from the Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study, with follow-up from 1988 and 1991 to 2020. Data from the National Health and Nutrition Examination Survey (NHANES) from the January 1, 2017, to December 31, 2018, cycle were used to compare risk profile distribution with that of the general U.S. population.
Study Details
A total of 195,453 participants (median age = 44 years at baseline; 81% female) were followed for a median of 12 years (interquartile range = 6–20 years). Among 81,151 individuals with negative colonoscopy screening results, 394 developed colorectal cancer. and 167 died of it. Among 114,302 individuals without screening colonoscopy, 2,229 developed colorectal cancer, and 637 died of it.
Negative colonoscopy screening results were consistently associated with a lower colorectal cancer incidence (hazard ratio [HR] = 0.51, 95% confidence interval [CI] = 0.44–0.58) and colorectal cancer mortality (HR = 0.56, 95% CI = 0.46–0.70) over 20 years of follow-up.
Among individuals with negative colonoscopy screening results, the 10-year cumulative colorectal cancer incidence of 0.78% among individuals with high-risk scores was not reached until 16 years among those with intermediate-risk scores and 25 years among those with low-risk scores.
The investigators concluded: “These findings provide evidence for shared decision-making between patients and physicians to consider extending the rescreening intervals after a [negative colonoscopy screening] result beyond the currently recommended 10 years, particularly for individuals with a low-risk profile. These results showed, as a proof of concepts, the importance of considering known [colorectal cancer] risk factors when making decisions for colonoscopy rescreening.”
Mingyang Song, MBBS, ScD, of the Department of Epidemiology, Harvard T.H. Chan School of Public Health, is the corresponding author of the JAMA Oncology article.
Disclosure: The study was supported by grants from the National Institutes of Health and others. For full disclosures of the study authors, visit jamanetwork.com.
