Screening Colonoscopy Intervals Could be Safely Extended for Some

Investigators who conducted a registry-based cross-sectional study of screening colonoscopies in Germany concluded that the standard practice of repeated screenings at 10-year intervals may warrant reconsideration following a negative screening colonoscopy.

“The prevalence of advanced neoplasms was 40% to 50% lower among 120,098 participants who underwent repeated screening colonoscopy 10 or more years after a negative colonoscopy than among all screening colonoscopies (1.25 million),” the authors reported in JAMA Internal Medicine.

Noting that “evidence of findings at screening colonoscopies conducted 10 or more years after a negative colonoscopy result is sparse,” the researchers set out to determine the prevalence of advanced adenomas and colorectal cancers among patients whose screening colonoscopy findings were reported to the German national registry during 2013-2019.

Of the more than 120,000 participants, 60.1% were women. Prevalence of advanced neoplasms or colorectal cancer was 3.6% among women and 5.2% among men 10 years after a negative screening colonoscopy. Those rates increased to 4.9% among women and 6.6% among men who had a negative colonoscopy 14 years or more earlier, compared with 7.1% and 11.6% among all screening colonoscopies.

“Sex-specific and age-specific prevalence of ADNs at repeated colonoscopies conducted 10 or more years after a negative colonoscopy were consistently at least 40% lower among women than among men, lower at younger vs older ages, and much lower than among all screening colonoscopies (standardized prevalence ratios for cancers: 0.22-0.38 among women, 0.15-0.24 among men; standardized prevalence ratios for ADNs: 0.49-0.62 among women, 0.50-0.56 among men),” the authors explained.

Because the rate of advanced neoplasms or cancer is quite low following a negative colonoscopy, the researchers stated, “Extension of the currently recommended 10-year screening intervals may be warranted, especially for female and younger participants without gastrointestinal symptoms.”

—Rebecca Mashaw

Reference:

Heisser T, Kretschmann J, Hagen B, et al. Prevalence of colorectal neoplasia 10 or more years after a negative screening colonoscopy in 120 000 repeated screening colonoscopies. JAMA Intern Med. Published online January 17, 2023. doi:10.1001/jamainternmed.2022.6215