Screening colonoscopy and risk of adverse events among individuals undergoing fecal immunochemical testing in a population-based program: A nested case-control study

Screening colonoscopy and risk of adverse events among individuals undergoing fecal... BackgroundScreening by means of biennial fecal occult blood test has provided a reduction in overall colorectal cancer mortality. Notwithstanding, we should not underestimate the harms that it can produce.AimThe aim of this article is to identify the independent risk factors of complications after a screening colonoscopy.MethodsA six-year, nested case-control study was conducted. Mortality/complications within 30 days after colonoscopy were registered and its predictors identified through logistic regression.ResultsAfter 39,254 colonoscopies, the complication rate was 1.0%. Independent predictors were sex (OR 1.68 for men; CI 95% 1.18–2.39), ASA physical status classification system (OR 1.73 for ASA II–III; CI 95% 1.53–3.69), history of abdominal surgery (OR 2.37; CI 95% 1.72–4.08), diverticulosis (OR 2.89; CI 95% 1.94–4.30), inadequate cleansing (OR 29.35; CI 95% 6.52–132.17), detection of advanced neoplasia (AN) (OR 4.92; CI 95% 3.29–7.36), detection of stage I adenocarcinoma (OR 9.44; CI 95% 4.46–20.0), polyps in right colon OR 2.27 CI 95% 1.38–3.74) and complex polypectomy (OR 2.00; CI 95% 1.25–3.20). The logistic model explained 82% of the complications (CI 95% 0.798–0.854, p < 0.001).ConclusionsColonoscopy, with or without removal of a lesion, is an invasive procedure with a non-deniable risk of major complications. Factors like inadequate cleansing or detection of AN are determinants. Therefore, it is vital to know which aspects predict their appearance to implement countermeasures. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png United European Gastroenterology Journal SAGE

Screening colonoscopy and risk of adverse events among individuals undergoing fecal immunochemical testing in a population-based program: A nested case-control study

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Publisher
SAGE
Copyright
© Author(s) 2018
ISSN
2050-6406
eISSN
2050-6414
D.O.I.
10.1177/2050640618756105
Publisher site
See Article on Publisher Site

Abstract

BackgroundScreening by means of biennial fecal occult blood test has provided a reduction in overall colorectal cancer mortality. Notwithstanding, we should not underestimate the harms that it can produce.AimThe aim of this article is to identify the independent risk factors of complications after a screening colonoscopy.MethodsA six-year, nested case-control study was conducted. Mortality/complications within 30 days after colonoscopy were registered and its predictors identified through logistic regression.ResultsAfter 39,254 colonoscopies, the complication rate was 1.0%. Independent predictors were sex (OR 1.68 for men; CI 95% 1.18–2.39), ASA physical status classification system (OR 1.73 for ASA II–III; CI 95% 1.53–3.69), history of abdominal surgery (OR 2.37; CI 95% 1.72–4.08), diverticulosis (OR 2.89; CI 95% 1.94–4.30), inadequate cleansing (OR 29.35; CI 95% 6.52–132.17), detection of advanced neoplasia (AN) (OR 4.92; CI 95% 3.29–7.36), detection of stage I adenocarcinoma (OR 9.44; CI 95% 4.46–20.0), polyps in right colon OR 2.27 CI 95% 1.38–3.74) and complex polypectomy (OR 2.00; CI 95% 1.25–3.20). The logistic model explained 82% of the complications (CI 95% 0.798–0.854, p < 0.001).ConclusionsColonoscopy, with or without removal of a lesion, is an invasive procedure with a non-deniable risk of major complications. Factors like inadequate cleansing or detection of AN are determinants. Therefore, it is vital to know which aspects predict their appearance to implement countermeasures.

Journal

United European Gastroenterology JournalSAGE

Published: Jun 1, 2018

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