JAMA Oncol

What does a negative screening colonoscopy mean for long-term cancer incidence, mortality?

December 27, 2024

Study design: This cohort study analyzed data from three prospective U.S. population-based cohorts: the Nurses’ Health Study, Nurses’ Health Study II, and the Health Professionals Follow-up Study, with follow-up from 1988 and 1991 to 2020. The analysis included 195,453 participants, comparing colorectal cancer (CRC) incidence and mortality between those with negative colonoscopy screening (NCS) results and those without endoscopy. Risk scores based on demographic and lifestyle factors were used to stratify participants.

Results: Negative colonoscopy screening results were associated with significantly lower CRC incidence (hazard ratio [HR], 0.51) and mortality (HR, 0.56) over 20 years compared with no endoscopy. Among individuals with NCS results, those with low-risk scores had a similar cumulative incidence of CRC at 25 years as high-risk individuals at 10 years.

Impact on clinical practice: The findings suggest that extending the rescreening interval beyond the currently recommended 10 years may be appropriate for individuals with low-risk profiles. This could lead to more personalized screening schedules, optimizing resource use and reducing patient burden without compromising safety.

Source:

Knudsen MD, et al. (2024, November 27). JAMA Oncol. Colorectal Cancer Incidence and Mortality After Negative Colonoscopy Screening Results. https://pubmed.ncbi.nlm.nih.gov/39602147/