Colonoscopy Rescreening Intervals Can be Extended for Low-Risk Patients

New research examining long-term outcomes following negative colonoscopy screening (NCS) results suggests that extending rescreening intervals beyond the current 10-year recommendation may be appropriate for patients with low-risk profiles.

The cohort study followed 195,453 participants from 3 prospective US-based studies for a median of 12 years. Among the 81,151 individuals with NCS results, both colorectal cancer (CRC) incidence and mortality were significantly lower for up to 20 years compared to those without endoscopy. CRC incidence was reduced by nearly half (hazard ratio [HR], 0.51; 95% CI, 0.44-0.58), and CRC mortality was also lower (HR, 0.56; 95% CI, 0.46-0.70). 

Risk stratification based on demographic and lifestyle factors further refined these findings. Individuals with low-risk scores (0-5) did not reach the 10-year cumulative incidence of CRC observed in high-risk individuals (scores 8-12) until 25 years after an NCS. Similarly, intermediate-risk individuals (scores 6-7) reached this threshold at 16 years. 

“These findings provide evidence to support shared decision-making for extending colonoscopy rescreening intervals beyond 10 years for low-risk individuals,” the authors noted. 

The study highlights the importance of incorporating risk stratification into rescreening decisions. "This proof of concept underscores the value of considering known CRC risk factors to personalize rescreening intervals," the authors wrote. 

Decisions should balance patient preferences, individual risk profiles, and healthcare resources. 

Reference
Knudsen MD, Wang K, Wang L, et al. Colorectal cancer incidence and mortality after negative colonoscopy screening results. JAMA Oncol. 2025;11(1):46-54. doi:10.1001/jamaoncol.2024.5227