Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, España.
Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, España.
Med Clin (Barc). 2018 Jan 12;150(1):1-7. doi: 10.1016/j.medcli.2017.04.015. Epub 2017 Jun 10.
A high quality colonoscopy is key in preventing colorectal cancer, but the risk of colorectal cancer (CRC) exists. The aims of the study were to investigate the incidence, characteristics and predictive factors of post-colonoscopy colorectal cancer (PCCRC).
A retrospective and prospective observational study was designed. A population undergoing colonoscopy between 1-01-1997 and 31-12-2014 was included. We analysed demographic variables, characteristics of the diagnostic colonoscopy of CRC, of the previous ones and the lesions found in them. To compare the PCCRC group versus the CRC group without previous colonoscopy, the Student's t-test and multiple logistic regression were used to determine predictive factors of PCCRC (SPSS 15). The statistical significance was P<.05.
A total of 56,984 colonoscopies, 1,977 CRC and 132 patients (mean 70.8 years old, 56.8% male) with at least one colonoscopy in 10 years before were registered (PCCRC). Seventy and a half percent of the previous colonoscopies were completed and 63.7% had an adequate bowel preparation. Predictive factors of PCCRC were personal history of polyps (OR 35.01; 95% CI 11.1-110.8; P<.001), previous CRC (OR 176.64; 95% CI 51.5-606.1); P<.001), family history of CRC (OR 3.14; 95% CI 1.5-6.4); P=.002) and proximal CRC (OR 3.15; 95% CI 2.1-4.9; P<.001).
PCCRC rate in 10 years was 6.7%. An adequate follow-up and a high-quality colonoscopy could prevent PCCRC, especially in patients with risk factors.
高质量的结肠镜检查是预防结直肠癌的关键，但结直肠癌（CRC）的风险依然存在。本研究旨在调查结肠镜检查后结直肠癌（PCCRC）的发病率、特征和预测因素。
设计了一项回顾性和前瞻性观察研究。纳入 1997 年 1 月 1 日至 2014 年 12 月 31 日期间接受结肠镜检查的人群。我们分析了人口统计学变量、CRC 诊断性结肠镜检查的特征、以前的结肠镜检查特征以及在这些检查中发现的病变。为了比较 PCCRC 组和没有以前结肠镜检查的 CRC 组，使用学生 t 检验和多因素逻辑回归来确定 PCCRC 的预测因素（SPSS 15）。统计学意义为 P<.05。
共登记了 56984 例结肠镜检查、1977 例 CRC 和 132 例（平均年龄 70.8 岁，56.8%为男性）至少在 10 年前进行过一次结肠镜检查（PCCRC）。70.5%的以前结肠镜检查完成，63.7%的肠道准备充分。PCCRC 的预测因素是个人息肉史（OR 35.01；95%CI 11.1-110.8；P<.001）、以前的 CRC（OR 176.64；95%CI 51.5-606.1）；P<.001）、CRC 家族史（OR 3.14；95%CI 1.5-6.4）；P=.002）和近端 CRC（OR 3.15；95%CI 2.1-4.9；P<.001）。
10 年内 PCCRC 发生率为 6.7%。充分的随访和高质量的结肠镜检查可以预防 PCCRC，尤其是在有危险因素的患者中。
