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Cited by 255

The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.

Five-Year Risk of Colorectal Neoplasia after Negative Screening Colonoscopy

Open access
Imperiale, Thomas F., Glowinski, Elizabeth A., Lin-Cooper, Ching, Larkin, Gregory N., Rogge, James D., Ransohoff, David F.·2008·New England Journal of Medicine

Abstract

BACKGROUND: The appropriate interval for endoscopic rescreening after a negative colonoscopic examination is uncertain. METHODS: We identified persons with no adenomas on baseline screening colonoscopy who returned at 5 years for follow-up colonoscopy. Findings were categorized according to the most advanced lesion present: no polyp, a hyperplastic polyp, a tubular adenoma less than 1 cm in diameter, an advanced adenoma (a tubular adenoma > or = 1 cm in diameter or a polyp with villous histologic features or high-grade dysplasia), or a cancer. RESULTS: Baseline screening colonoscopy had identified 2436 persons with no adenomas; 1256 of them (51.6%) were rescreened a mean (+/-SD) of 5.34+/-1.34 years later. The mean age of this group at baseline was 56.7 years; 56.7% of its members were men. No cancers were found on rescreening (95% confidence interval [CI] for the detection rate, 0 to 0.24%). One or more adenomas were found in 201 persons (16.0%). A total of 19 advanced adenomas, of which 10 (52.6%) were distal to the splenic flexure, were found in 16 persons (1.3%). The risk of an advanced adenoma did not differ significantly between persons with no polyps at baseline and those with hyperplastic polyps at baseline (1.1% [12 of 1057] and 2.0% [4 of 199], respectively; P=0.30). Men were more likely than women to have any adenoma (tubular less than 1 cm in diameter or advanced) (relative risk, 1.88; 95% CI, 1.42 to 2.51) and to have an advanced adenoma (relative risk, 3.31; 95% CI, 1.02 to 10.8). CONCLUSIONS: Among persons with no colorectal neoplasia on initial screening colonoscopy, the 5-year risk of colorectal cancer is extremely low. The risk of advanced adenoma is also low, although it is higher among men than among women. Our findings support a rescreening interval of 5 years or longer after a normal colonoscopic examination.

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Crossref · 10.1056/nejmoa0803597

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Metadata

Authors
Imperiale, T. F., Glowinski, E. A., Lin-Cooper, C., Larkin, G. N., Rogge, J. D., & Ransohoff, D. F.
Venue
New England Journal of Medicine
Published
2008-09-18
Volume
359
Issue
12
Pages
1218-1224
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2098809478
Cited by
255
References
24
FWCI
10.16
Type
journal article
Language
en
Open access
bronze

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