ArticleJournal of medical screening2025
Long-term colorectal cancer incidence in a post-endoscopic screening cohort, accounting for surveillance, by baseline polyp group, anatomic subsite, and sex.
Article in Journal of medical screening, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
ObjectivesColonoscopy surveillance is often performed in post-polypectomy cohorts, likely altering colorectal cancer (CRC) outcomes, but this is often not addressed in CRC incidence analyses. We examined CRC incidence post-endoscopic screening, accounting for surveillance.MethodsWe examined UK Flexible Sigmoidoscopy Screening Trial participants who had no, low-risk, or high-risk (≥10 mm, ≥3 adenomas, adenomas with villous features/high-grade dysplasia) distal polyps at screening. Participants with high-risk polyps had an index colonoscopy and 81% had ≥1 surveillance colonoscopies post-screening; <1% of those with no/low-risk polyps had an index or surveillance colonoscopy. We examined CRC incidence over 21 years by anatomic subsite and sex. Standardised incidence ratios (SIRs) compared incidence to general population incidence.ResultsOf 39,417 participants, 29,792 (76%), 8162 (21%), and 1463 (4%) had no, low-risk, and high-risk polyps, respectively. In the high-risk group, all-site CRC incidence was non-significantly different from that in the general population, when including all participants, just those who attended surveillance, or just those who did not attend surveillance (SIRs: 0.81 [95% confidence interval: 0.60-1.07]; 0.75 [0.54-1.03]; 1.12 [0.56-2.01], respectively). Without surveillance, compared to the general population, distal cancer incidence was lower among women and men without polyps (SIRs: 0.30 [0.24-0.37]; 0.24 [0.20-0.29], respectively) and women and men with low-risk polyps (SIRs: 0.52 [0.34-0.76]; 0.27 [0.19-0.37], respectively); proximal cancer incidence was lower among men without polyps (SIR: 0.75 [0.64-0.88]), non-significantly different among women without polyps (SIR: 1.07 [0.93-1.22]) and men with low-risk polyps (SIR: 1.22 [0.98-1.51]), but higher among women with low-risk polyps (SIR: 2.22 [1.77-2.76]).ConclusionsWomen with low-risk distal polyps at flexible sigmoidoscopy screening had double the risk of proximal colon cancer, compared to the general population.
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