Surveillance interval of endoscopic examinations for colorectal cancer screening

Abstract

Background: There have been a few evidence‐based studies concerning the relationship between the length of the surveillance interval of colonoscopic examinations and the risk of colorectal cancer (CRC). The aim of the present study was to assess the appropriate interval between endoscopic examinations for CRC screening in a retrospective cohort study.Methods: The cohort included subjects in whom cancer was not detected at the initial endoscopic examination and in whom endoscopic examination(s) was subsequently performed one or more times. The results of the endoscopic examinations performed in the mass screening for CRC between November 1983 and March 1999 were analyzed. The study end point was the detection of CRC and the detection rates of cancer were assessed among those who underwent examinations at various intervals between successive endoscopic examinations.Results: Among the 117 636 cohort subjects, 63 invasive cancer cases and 112 mucosal cancer cases were found. The odds ratio (OR) for invasive cancer was not significantly elevated even when the interval between successive examinations was over 5 years. The OR for mucosal or invasive cancer was significantly elevated among the subjects in whom the interval between successive examinations was over 5 years (OR, 1.71; 95% confidence interval (CI), 1.07–2.73), than among those in whom the interval was 1 year.Conclusions: Since prolongation of the interval between endoscopic examinations of up to 5 years did not result in any change in the cancer risk among persons who are at average risk for CRC, 5 years may be an adequate interval between endoscopic examinations in the mass screening for CRC.