A81 POST COLONOSCOPY COLORECTAL CANCERS IN MANITOBA: A POPULATION-BASED ANALYSIS

Abstract Background Recent consensus guidelines from the World Endoscopy Organization (WEO) recommend all jurisdictions report unadjusted rates of post colonoscopy (PC) colorectal cancers (CRC). Until recently, prior reports have mostly focused on PC-CRC in the CRC screening age groups. Aims We eval...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the Canadian Association of Gastroenterology 2020-02, Vol.3 (Supplement_1), p.95-96
Main Authors: Singh, H, Derksen, S, Sirski, M, McCulloch, S, Lix, L M
Format: Article
Language:English
Subjects:
Poster Presentation
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Recent consensus guidelines from the World Endoscopy Organization (WEO) recommend all jurisdictions report unadjusted rates of post colonoscopy (PC) colorectal cancers (CRC). Until recently, prior reports have mostly focused on PC-CRC in the CRC screening age groups. Aims We evaluated the rate and predictors of PC-CRC in the adult population for the province of Manitoba from 1990 to 2016. Methods Individuals 18+ years at CRC diagnosis were identified from the Manitoba Cancer Registry. Colonoscopies in the 3 years preceding CRC diagnosis were identified via linkage to Manitoba Health (MH) physicians billing claims. CRCs were classified, based on WEO recommendations, as: (1) detected CRC (colonoscopy up to 6 months before CRC diagnosis) and (2) PC-CRC-3y (colonoscopy 6–36 months before CRC diagnosis). Generalized linear models with generalized estimating equations (to adjust for clustering within endoscopy physicians) were used to test for differences in rates over 3-time intervals (1990/91 – 1999/00; 2000/01 - 2009/10; 2010/11 – Dec 31 2016), provincial region of performance of colonoscopy and identify other associations from the MH data. Results Overall, 10.5% of the 16,639 CRCs diagnosed in the study period and with colonoscopy in the preceding 3 years were PC-CRC-3y. CRCs diagnosed between April 2000 and March 2010 were more likely to be PC-CRC-3y than those diagnosed between April 2010 and December 2016 (odds ratio [OR] 1.18; 95% confidence interval [CI]: 1.03–1.37). Female sex (OR for male: 0.86; 95% CI: 0.77–0.94), IBD diagnosis (OR 3.04; 95% CI: 2.56–4.52), prior CRC (OR 5.41; 95% CI: 4.61–6.34), prior colonoscopy (OR 2.10; 95% CI 1.88–2.36), diverticulosis (OR 2.39; 95% CI: 2.16–2.6), colonoscopy by GP (OR: 1.62; 95% CI 1.16–2.26 vs. surgeons) were associated with increased odds of PC-CRC-3y. There were no regional differences, and no effect of colonoscopy volume or age greater than 75 (or lower than 50). Conclusions In Manitoba, the PC-CRC-3y rate decreased slightly in recent years. The study results of large number of PC-CRC-3y along with only a slight decrease in rates over the years, support calls for root cause analysis to evaluate individual cases of PC-CRC. An initial focus could be the groups with increased risk of PC-CRC. Funding Agencies Manitoba Health
ISSN:2515-2084
2515-2092
DOI:10.1093/jcag/gwz047.080