Tu1185 Should Diabetes Mellitus Be an Indication for Earlier Colorectal Cancer Screening?

Abstract

educational level, and body mass index. Results: Colonoscopy was associated with a statistically significant decreased risk of rectal or left colon cancers (HR=0.58; 95% CI=0.43-0.78 and HR=0.37; 95% CI=0.26-0.52 respectively) but not of right colon cancers (HR=0.85; 95% CI=0.63-1.16). Associations were stronger for several declarations of colonoscopy but did not significantly differ according to stage at diagnosis. Concerning right colon cancers, although associations were not statistically significant, results were stronger for cancers diagnosed at an advanced stage (HR=0.70; 95% CI=0.45-1.10) and for several declarations of colonoscopy (HR=0.71; 95% CI=0.47-1.08). FHCC was associated with an increased risk of adenomas and especially non-advanced adenomas but a non-statistically significant increased risk of colorectal cancer. However, the risk of colorectal cancer was significantly increased in women who had a FHCC but no history of colonoscopy (HR=1.80; 95% CI= 1.36-2.40), but not in women with FHCC and previous colonoscopies (HR=1.10; 95% CI= 0.76-1.61), P for interaction between colonoscopy and FHCC = 0.06. Conclusion: This prospective study confirms the efficiency of colonoscopy regarding distal tumors while adding to the body of evidence for its low efficiency at preventing right colon cancer. While subjects with a FHCC have an approximately 80% excess risk of colorectal cancer, colonoscopy screening reduces their risk to that of subjects with no FHCC. Effort should be made for improving colonoscopy efficiency towards detection of proximal adenomas or early cancers, through adequate colon preparation and careful examination of the cecum.