Abstract
Original language | English |
---|---|
Journal | Clinical Gastroenterology and Hepatology |
Early online date | 2021 |
DOIs | |
Publication status | E-pub ahead of print - 2021 |
Keywords
- Colonoscopy
- Colonoscopy Quality
- Colorectal Neoplasms
- HNPCC
- Hereditary Colorectal Cancer
- Hereditary Nonpolyposis Colorectal Cancer
- Lynch Syndrome
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In: Clinical Gastroenterology and Hepatology, 2021.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Quality of Colonoscopy Is Associated With Adenoma Detection and Postcolonoscopy Colorectal Cancer Prevention in Lynch Syndrome
AU - Sánchez, Ariadna
AU - Roos, Victorine H.
AU - Navarro, Matilde
AU - Pineda, Marta
AU - Caballol, Berta
AU - Moreno, Lorena
AU - Carballal, Sabela
AU - Rodríguez-Alonso, Lorena
AU - Ramon y Cajal, Teresa
AU - Llort, Gemma
AU - Piñol, Virginia
AU - López-Fernández, Adrià
AU - Salces, Inmaculada
AU - Picó, Maria Dolores
AU - Rivas, Laura
AU - Bujanda, Luis
AU - Garzon, Marta
AU - Pizarro, Angeles
AU - Martinez de Castro, Eva
AU - López-Arias, Maria Jesus
AU - Poves, Carmen
AU - Garau, Catalina
AU - Rodriguez-Alcalde, Daniel
AU - Herraiz, Maite
AU - Alvarez-Urrutia, Cristina
AU - Dacal, Andres
AU - Carrillo-Palau, Marta
AU - Cid, Lucia
AU - Ponce, Marta
AU - Barreiro-Alonso, Eva
AU - Saperas, Esteban
AU - Aguirre, Elena
AU - Romero, Cristina
AU - Bastiaansen, Barbara
AU - Gonzalez-Acosta, Maribel
AU - Morales-Romero, Blai
AU - Ocaña, Teresa
AU - Rivero-Sánchez, Liseth
AU - Jung, Gerhard
AU - Bessa, Xavier
AU - Cubiella, Joaquin
AU - Jover, Rodrigo
AU - Rodríguez-Moranta, Francisco
AU - Balmaña, Judith
AU - Brunet, Joan
AU - Castells, Antoni
AU - Dekker, Evelien
AU - Capella, Gabriel
AU - Serra-Burriel, Miquel
AU - Moreira, Leticia
AU - Pellise, Maria
AU - Balaguer, Francesc
N1 - Funding Information: Funding This study was funded by the Instituto de Salud Carlos III through projects PI16/00766, PI19/01867, PI19/01050, PI14/01386, PI17/01756, PI17/00837, and PI16/11363 (co-funded by the European Regional Development Fund; “A way to make Europe”); and by the Agència de Gestió d'Ajuts Universitaris i de Recerca (Generalitat de Catalunya, Grup de Recerca Consolidat (GRC) 2017SGR653). The Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas is funded by the Instituto de Salud Carlos III. This work also was funded by the Spanish Ministry of Economy and Competitiveness and co-funded by Fondo Europeo de Desarrollo Regional (FEDER) funds “A Way to Build Europe” (SAF2015-68016-R), Centro de Investigación Biomédica en Red Cancer (CIBERONC), and the Government of Catalonia (2017SGR1282). The BufaLynch Association supports and funds the Institut Catala d'Oncologia (ICO)’s Lynch syndrome database. None of the funding parties were involved in the collection, analysis, or interpretation of data. Funding Information: Funding This study was funded by the Instituto de Salud Carlos III through projects PI16/00766, PI19/01867, PI19/01050, PI14/01386, PI17/01756, PI17/00837, and PI16/11363 (co-funded by the European Regional Development Fund; ?A way to make Europe?); and by the Ag?ncia de Gesti? d'Ajuts Universitaris i de Recerca (Generalitat de Catalunya, Grup de Recerca Consolidat (GRC) 2017SGR653). The Centro de Investigaci?n Biom?dica en Red en Enfermedades Hep?ticas y Digestivas is funded by the Instituto de Salud Carlos III. This work also was funded by the Spanish Ministry of Economy and Competitiveness and co-funded by Fondo Europeo de Desarrollo Regional (FEDER) funds ?A Way to Build Europe? (SAF2015-68016-R), Centro de Investigaci?n Biom?dica en Red Cancer (CIBERONC), and the Government of Catalonia (2017SGR1282). The BufaLynch Association supports and funds the Institut Catala d'Oncologia (ICO)?s Lynch syndrome database. None of the funding parties were involved in the collection, analysis, or interpretation of data. Funding Information: Conflicts of interest These authors disclose the following: Francesc Balaguer has received endoscopic equipment on loan from Fujifilm, received an honorarium for consultancy from Sysmex and Cancer Prevention Pharmaceuticals (CPP), speaker’s fees from Norgine, and editorial fees from Elsevier; Ariadna Sánchez has received speaker’s fees from Janssen; Maria Pellise has received research grants from Fujifilm Spain, Fujifilm Europe, and Casen Recordati, equipment on Loan from Fujifilm Europe, consultancy fees from Norgine Iberia, speaker’s fees from Norgine, Olympus, Casen Recordati, and Janssen, and editorial fees from Thieme; Lorena Rodríguez-Alonso has received speaker's fees from Takeda, MSD, and Falk, and received an honorarium for consultancy from AbbVie; Evelien Dekker has received endoscopic equipment on loan from FujiFilm, has received a research grant from FujiFilm, has received honorarium for consultancy from FujiFilm, Olympus, Tillots, GI Supply, and CPP-FAP, and speaker’s fees from Olympus, Roche, and GI Supply, and serves on the supervisory board of eNose; and Rodrigo Jover has received honorarium for consultancy and speaker's fees from Norgine, MSD, GI Supply, and CPP. The remaining authors disclose no conflicts. Publisher Copyright: © 2021 AGA Institute
PY - 2021
Y1 - 2021
N2 - Background & Aims: Colonoscopy reduces colorectal cancer (CRC) incidence and mortality in Lynch syndrome (LS) carriers. However, a high incidence of postcolonoscopy CRC (PCCRC) has been reported. Colonoscopy is highly dependent on endoscopist skill and is subject to quality variability. We aimed to evaluate the impact of key colonoscopy quality indicators on adenoma detection and prevention of PCCRC in LS. Methods: We conducted a multicenter study focused on LS carriers without previous CRC undergoing colonoscopy surveillance (n = 893). Incident colorectal neoplasia during surveillance and quality indicators of all colonoscopies were analyzed. We performed an emulated target trial comparing the results from the first and second surveillance colonoscopies to assess the effect of colonoscopy quality indicators on adenoma detection and PCCRC incidence. Risk analyses were conducted using a multivariable logistic regression model. Results: The 10-year cumulative incidence of adenoma and PCCRC was 60.6% (95% CI, 55.5%–65.2%) and 7.9% (95% CI, 5.2%–10.6%), respectively. Adequate bowel preparation (odds ratio [OR], 2.07; 95% CI, 1.06–4.3), complete colonoscopies (20% vs 0%; P =.01), and pan-chromoendoscopy use (OR, 2.14; 95% CI, 1.15–3.95) were associated with significant improvement in adenoma detection. PCCRC risk was significantly lower when colonoscopies were performed during a time interval of less than every 3 years (OR, 0.35; 95% CI, 0.14–0.97). We observed a consistent but not significant reduction in PCCRC risk for a previous complete examination (OR, 0.16; 95% CI, 0.03–1.28), adequate bowel preparation (OR, 0.64; 95% CI, 0.17–3.24), or previous use of high-definition colonoscopy (OR, 0.37; 95% CI, 0.02–2.33). Conclusions: Complete colonoscopies with adequate bowel preparation and chromoendoscopy use are associated with improved adenoma detection, while surveillance intervals of less than 3 years are associated with a reduction of PCCRC incidence. In LS, high-quality colonoscopy surveillance is of utmost importance for CRC prevention.
AB - Background & Aims: Colonoscopy reduces colorectal cancer (CRC) incidence and mortality in Lynch syndrome (LS) carriers. However, a high incidence of postcolonoscopy CRC (PCCRC) has been reported. Colonoscopy is highly dependent on endoscopist skill and is subject to quality variability. We aimed to evaluate the impact of key colonoscopy quality indicators on adenoma detection and prevention of PCCRC in LS. Methods: We conducted a multicenter study focused on LS carriers without previous CRC undergoing colonoscopy surveillance (n = 893). Incident colorectal neoplasia during surveillance and quality indicators of all colonoscopies were analyzed. We performed an emulated target trial comparing the results from the first and second surveillance colonoscopies to assess the effect of colonoscopy quality indicators on adenoma detection and PCCRC incidence. Risk analyses were conducted using a multivariable logistic regression model. Results: The 10-year cumulative incidence of adenoma and PCCRC was 60.6% (95% CI, 55.5%–65.2%) and 7.9% (95% CI, 5.2%–10.6%), respectively. Adequate bowel preparation (odds ratio [OR], 2.07; 95% CI, 1.06–4.3), complete colonoscopies (20% vs 0%; P =.01), and pan-chromoendoscopy use (OR, 2.14; 95% CI, 1.15–3.95) were associated with significant improvement in adenoma detection. PCCRC risk was significantly lower when colonoscopies were performed during a time interval of less than every 3 years (OR, 0.35; 95% CI, 0.14–0.97). We observed a consistent but not significant reduction in PCCRC risk for a previous complete examination (OR, 0.16; 95% CI, 0.03–1.28), adequate bowel preparation (OR, 0.64; 95% CI, 0.17–3.24), or previous use of high-definition colonoscopy (OR, 0.37; 95% CI, 0.02–2.33). Conclusions: Complete colonoscopies with adequate bowel preparation and chromoendoscopy use are associated with improved adenoma detection, while surveillance intervals of less than 3 years are associated with a reduction of PCCRC incidence. In LS, high-quality colonoscopy surveillance is of utmost importance for CRC prevention.
KW - Colonoscopy
KW - Colonoscopy Quality
KW - Colorectal Neoplasms
KW - HNPCC
KW - Hereditary Colorectal Cancer
KW - Hereditary Nonpolyposis Colorectal Cancer
KW - Lynch Syndrome
UR - http://www.scopus.com/inward/record.url?scp=85118739568&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.cgh.2020.11.002
DO - https://doi.org/10.1016/j.cgh.2020.11.002
M3 - Article
C2 - 33157315
SN - 1542-3565
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
ER -