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dc.contributor.authorGrobbee, E.
dc.contributor.authorKapidzic, A.
dc.contributor.authorvan Vuuren, A.
dc.contributor.authorvan Leerdam, M.
dc.contributor.authorLansdorp-Vogelaar, Iris
dc.contributor.authorLooman, C.
dc.contributor.authorBruno, M.
dc.contributor.authorKuipers, E.
dc.contributor.authorSpaander, M.
dc.identifier.citationGrobbee, E. and Kapidzic, A. and van Vuuren, A. and van Leerdam, M. and Lansdorp-Vogelaar, I. and Looman, C. and Bruno, M. et al. 2015. Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening. American Journal of Gastroenterology. 110 (7): pp. 1072-1077.

Objectives: Fecal immunochemical testing (FIT) and colonoscopy are tandem procedures in colorectal cancer (CRC) screening. A positive FIT predicts advanced neoplasia (AN) that requires endoscopic detection and removal. En bloc or piecemeal resection of AN is associated with a significant rate of residual or recurrent neoplasia. Second-look colonoscopies are indicated to assess completeness of removal of AN. These colonoscopies can make a substantial demand on colonoscopy capacity and health-care system. This study is the first to evaluate the demand and risk factors for second-look colonoscopy in FIT CRC screening. Methods: All colonoscopies after a positive FIT, in subjects aged 50–74 years approached for 3 rounds of FIT screening, were prospectively registered. Second-look colonoscopies were defined as any colonoscopy within 1 year following a colonoscopy after positive FIT. Results: Out of 1,215 FIT-positive screenees undergoing colonoscopy, 105 (8.6%) patients underwent a second-look colonoscopy, of whom 30 (2.5%) underwent more than one colonoscopy (range 2–9), leading to a total of 149 (12.3%) additional colonoscopies. Main reasons for second-look colonoscopies were assessment of complete AN removal (41.9%) and need for additional polypectomy (34.3%). Risk factors were advanced adenomas and poor bowel preparation (P<0.001). High fecal hemoglobin concentration was the only predictor of a second-look colonoscopy before index colonoscopy (P<0.001). Conclusions: Second-look colonoscopies have substantial impact on colonoscopy resources, increasing the demand with 12%. The main reasons for these second-look colonoscopies were previous incomplete polypectomy and control of completeness of removal of neoplastic lesions. A high fecal hemoglobin concentration as measured by FIT can help to identify patients at risk of a second-look colonoscopy.

dc.publisherNature Publishing Group
dc.titleSecond-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening
dc.typeJournal Article
dcterms.source.titleAmerican Journal of Gastroenterology
curtin.accessStatusFulltext not available

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