Endoscopy 2022; 54(S 01): S74
DOI: 10.1055/s-0042-1744736
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CT-COLONOGRAPHY IN FECAL IMMUNOCHEMICAL TEST POSITIVE PATIENTS IN A COLORECTAL CANCER SCREENING PROGRAM – YIELD AND INCIDENCE OF INTERVAL CARCINOMAS

S. Moen
1   Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam, Netherlands
,
F.E. Marijnissen
1   Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam, Netherlands
,
J.S. Terhaar Sive Droste
2   Jeroen Bosch Hospital, Department of Gastroenterology and Hepatology, 's Hertogenbosch, Netherlands
,
W.H. de Vos tot Nederveen Cappel
3   Isala Hospital, Department of Gastroenterology and Hepatology, Zwolle, Netherlands
,
M.B.W. Spanier
4   Rijnstate Hospital, Department of Gastroenterology and Hepatology, Arnhem, Netherlands
,
J.F. Huisman
3   Isala Hospital, Department of Gastroenterology and Hepatology, Zwolle, Netherlands
,
E. Dekker
5   Amsterdam University Medical Center location AMC, Department of Gastroenterology and Hepatology, Amsterdam, Netherlands
,
J. Stoker
6   Amsterdam University Medical Centers, Department of Radiology and Nuclear Medicine, Amsterdam, Netherlands
,
E.J. Kuipers
1   Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam, Netherlands
,
M.G.J. Thomeer
7   Erasmus MC University Medical Center, Department of Radiology, Rotterdam, Netherlands
,
M.C.W. Spaander
1   Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam, Netherlands
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Aims In the Dutch colorectal cancer (CRC) screening program, fecal immunochemical test (FIT) positive screenees are offered CT-colonography (CTC) when colonoscopy is not possible due to contraindications or patient preferences. Literature on CTC screening in FIT-positives is scarce and incidence of interval carcinomas for this population is yet unknown.

Methods In this retrospective study, we assessed yield and incidence of interval carcinomas in FIT-positive screenees who directly underwent CTC between 2014-2019 in the Dutch CRC screening program. Centers with>50 CTC’s were approached for data collection. Data were linked with the National Cancer Registry to identify interval carcinomas.

Results Out of 2983 FIT-positive screenees (mean age 68.2 years) scheduled for CTC, 2794 (93.7%) underwent CTC. Most advanced lesion detected by CTC was CRC in 160 (5.7%), polyps>10mm in 533 (19.1%) and polyps<10mm in 478 (17.1%) screenees. A total of 987 (35.3%) additional endoscopies were performed. Histologically confirmed advanced neoplasia was present in 587 (21%) screenees. Most advanced histologically confirmed lesion was CRC in 109 (3.9%) and advanced adenoma in 478 (17.1%) screenees. Two CTC detected CRC’s were confirmed by radiological imaging and four CTC detected CRC’s did not receive further examination. A total of 16 (0.6%) interval carcinomas occurred after a median follow-up of 49 months (range 11-92).

Conclusions CTC detected advanced neoplasia in only 21% of FIT-positive screenees and a substantial proportion of post-CTC interval carcinomas was found. This underlines the need for a structured quality assurance program for CTC’s performed in FIT-positive screenees.



Publication History

Article published online:
14 April 2022

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