TY - JOUR
T1 - Risk of Incident Colorectal Cancer and Death After Colonoscopy
T2 - A Population-based Study in Utah
AU - Samadder, N. Jewel
AU - Curtin, Karen
AU - Pappas, Lisa
AU - Boucher, Ken
AU - Mineau, Geraldine P.
AU - Smith, Ken
AU - Fraser, Alison
AU - Wan, Yuan
AU - Provenzale, Dawn
AU - Kinney, Anita Y.
AU - Ulrich, Cornelia
AU - Burt, Randall W.
N1 - Funding Information:
Funding Support for this project was provided by National Cancer Institute grants P01-CA073992 (R.W.B.), R01-CA040641 (R.W.B.), an Endoscopic Research Award from the American Society for Gastrointestinal Endoscopy (N.J.S.), and a junior faculty career development award from the American College of Gastroenterology (N.J.S.). Partial support for the Utah Population Database and this project was provided by the Huntsman Cancer Institute Cancer Center Support Grant P30CA042014 from the National Cancer Institute and the Huntsman Cancer Foundation. Support for the Utah Cancer Registry is pro- vided by contract #HHSN 261201000026C from the National Cancer Institute with additional support from the Utah Department of Health and the University of Utah.
Funding Information:
Funding Support for this project was provided by National Cancer Institute grants P01-CA073992 (R.W.B.), R01-CA040641 (R.W.B.), an Endoscopic Research Award from the American Society for Gastrointestinal Endoscopy (N.J.S.), and a junior faculty career development award from the American College of Gastroenterology (N.J.S.). Partial support for the Utah Population Database and this project was provided by the Huntsman Cancer Institute Cancer Center Support Grant P30CA042014 from the National Cancer Institute and the Huntsman Cancer Foundation. Support for the Utah Cancer Registry is provided by contract #HHSN 261201000026C from the National Cancer Institute with additional support from the Utah Department of Health and the University of Utah.
Publisher Copyright:
© 2016 AGA Institute.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background & Aims: Colonoscopy is widely recommended for colorectal (CRC) screening in the United States, but evidence of effectiveness is limited. We examined whether exposure to colonoscopy decreases the odds of incident CRC and death from CRC in Utah. Methods: We performed a case-control study of Utah residents, 54 to 90 years old, who received a CRC diagnosis from 2000 through 2010 (cases). Age- and sex-matched controls with no history of CRC (controls) were selected for each case. We determined receipt of colonoscopy 6 months to 10 years before the reference date for each case and control through administrative claims data. Colonoscopy exposure was compared by using conditional logistic regression. Results: We identified 5128 cases and 20,512 controls; 741 cases (14%) and 5715 controls (28%) received a colonoscopy. Exposure to colonoscopy reduced the odds for a diagnosis of CRC; the odds ratios (ORs) were 0.41 for any CRC (95% confidence interval [CI], 0.38-0.44), 0.58 for proximal colon cancer (95% CI, 0.51-0.65), and 0.29 for distal colon or rectal cancer (95% CI, 0.25-0.33). This finding was consistent among sexes, age groups, and cancer stages. Similarly, in a subgroup analysis, colonoscopy was associated with decreased odds of death from CRC (OR, 0.33; 95% CI, 0.28-0.39) in both the proximal colon (OR, 0.43; 95% CI, 0.34-0.55) and distal colon or rectum (OR, 0.23; 95% CI, 0.18-0.30). Conclusions: In the population of Utah, colonoscopy is associated with a large reduction in risk of new-onset CRC and death from CRC. This reduction in risk for CRC was greatest for the distal colon and rectum, with a more modest reduction for proximal colon cancer.
AB - Background & Aims: Colonoscopy is widely recommended for colorectal (CRC) screening in the United States, but evidence of effectiveness is limited. We examined whether exposure to colonoscopy decreases the odds of incident CRC and death from CRC in Utah. Methods: We performed a case-control study of Utah residents, 54 to 90 years old, who received a CRC diagnosis from 2000 through 2010 (cases). Age- and sex-matched controls with no history of CRC (controls) were selected for each case. We determined receipt of colonoscopy 6 months to 10 years before the reference date for each case and control through administrative claims data. Colonoscopy exposure was compared by using conditional logistic regression. Results: We identified 5128 cases and 20,512 controls; 741 cases (14%) and 5715 controls (28%) received a colonoscopy. Exposure to colonoscopy reduced the odds for a diagnosis of CRC; the odds ratios (ORs) were 0.41 for any CRC (95% confidence interval [CI], 0.38-0.44), 0.58 for proximal colon cancer (95% CI, 0.51-0.65), and 0.29 for distal colon or rectal cancer (95% CI, 0.25-0.33). This finding was consistent among sexes, age groups, and cancer stages. Similarly, in a subgroup analysis, colonoscopy was associated with decreased odds of death from CRC (OR, 0.33; 95% CI, 0.28-0.39) in both the proximal colon (OR, 0.43; 95% CI, 0.34-0.55) and distal colon or rectum (OR, 0.23; 95% CI, 0.18-0.30). Conclusions: In the population of Utah, colonoscopy is associated with a large reduction in risk of new-onset CRC and death from CRC. This reduction in risk for CRC was greatest for the distal colon and rectum, with a more modest reduction for proximal colon cancer.
KW - Colon Cancer
KW - Detection
KW - Endoscopy
KW - Neoplasm
KW - Prevention
KW - Tumor
KW - US
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UR - http://www.scopus.com/inward/citedby.url?scp=84958891022&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2015.08.033
DO - 10.1016/j.cgh.2015.08.033
M3 - Article
C2 - 26343183
AN - SCOPUS:84958891022
SN - 1542-3565
VL - 14
SP - 279-286.e2
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 2
ER -