Clinical and endoscopic characteristics of post-colonoscopy colorectal cancers detected within 10 years after a previous negative examination

Kenta Kodama; Shin-ei Kudo; Hideyuki Miyachi; Kunihiko Wakamura; Yasuharu Maeda; Katsuro Ichimasa; Yushi Ogawa; Yuta Kouyama; Masahiro Abe; Yohei Ogura; Taishi Okumura; Kenichi Mochizuki; Yosuke Minegishi; Misaki Ishiyama; Yuichi Mori; Masashi Misawa; Toyoki Kudo; Takemasa Hayashi; Fumio Ishida; Daisuke Watanabe

doi:10.1055/a-1518-6754

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endoscopy 2021; 09(10): E1472-E1479
DOI: 10.1055/a-1518-6754

Original article

Clinical and endoscopic characteristics of post-colonoscopy colorectal cancers detected within 10 years after a previous negative examination^[*]

Kenta Kodama‡

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

²Division of Gastroenterology, Japanese Red Cross Society Fukushima Hospital, Fukushima, Japan

,

Shin-ei Kudo

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Hideyuki Miyachi‡

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Kunihiko Wakamura

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Yasuharu Maeda

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Katsuro Ichimasa

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Yushi Ogawa

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Yuta Kouyama

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Masahiro Abe

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Yohei Ogura

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Taishi Okumura

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Kenichi Mochizuki

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Yosuke Minegishi

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Misaki Ishiyama

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Yuichi Mori

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Masashi Misawa

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Toyoki Kudo

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Takemasa Hayashi

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Fumio Ishida

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Daisuke Watanabe

³Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

⁴Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States

› Author Affiliations

Abstract

Background and study aims We sometimes encounter colorectal cancer (CRC) that is discovered during the time interval between initial colonoscopy and the recommended follow-up examination. Although several studies reported such cases of CRC, most were based on registry data, which implied that the endoscopic quality was not consistent or guaranteed. We aimed to clarify these clinical and endoscopic characteristics at our high-volume center where a retrospective survey could be precisely performed.

Patients and methods We retrospectively analyzed patients with CRC who underwent endoscopic resection or surgery from April 2002 to December 2010, categorizing them into two groups: a “study group” of patients with a negative colonoscopy during the previous 10 years, and a “control group” of patients without a previous colonoscopy or with a previous colonoscopy more than 10 years prior.

Results A total of 2042 patients had CRC, among which 55 patients were classified into the study group and the remaining 1989 into the control group. The CRC cases in the study group showed a significant association with smaller (< 30 mm) tumor size (odds ratio [OR] 2.3; 95 % confidence interval [CI] 1.3–4.0) and proximal tumor site (OR 1.7; 95 %CI 0.9–2.9). In addition, right-sided and depressed-type T1 CRCs were significantly more common in the study group.

Conclusions Tumor size and location were associated with CRCs detected within 10 years after the negative examination. In addition, depressed-type T1 CRCs were more common. Therefore, we should pay more attention to small, right-sided, or depressed-type tumors in daily colonoscopy.

Full Text

References

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Clinical and endoscopic characteristics of post-colonoscopy colorectal cancers detected within 10 years after a previous negative examination[*]

Clinical and endoscopic characteristics of post-colonoscopy colorectal cancers detected within 10 years after a previous negative examination^[*]