Kawamura Takuji, Oda Yasushi, Toyoizumi Hirobumi, Kato Masayuki, Sekiguchi Masau, Takamaru Hiroyuki, Mizuguchi Yasuhiko, Horiguchi Go, Kobayashi Kiyonori, Sada Miwa, Yokoyama Akira, Utsumi Takahiro, Tsuji Yosuke, Ohki Daisuke, Takeuchi Yoji, Shichijo Satoki, Ikematsu Hiroaki, Matsuda Koji, Teramukai Satoshi, Kobayashi Nozomu, Matsuda Takahisa, Saito Yutaka, Tanaka Kiyohito
Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
Oda GI Endoscopy and Gastroenterology Clinic, Kumamoto, Japan.
J Gastroenterol Hepatol. 2025 Jan;40(1):153-158. doi: 10.1111/jgh.16796. Epub 2024 Oct 31.
The risk of colorectal cancer among fecal immunochemistry test-positive individuals who had undergone previous colonoscopies remains unclear. Therefore, this study aimed to determine the differences in the risk of colorectal cancer among fecal immunochemistry test-positive individuals according to the timing of their previous colonoscopies.
This multicenter, retrospective, observational study was conducted in Japan as a subgroup analysis of the J-SCOUT study (UMIN000040690), which integrated and analyzed a database comprising all colonoscopies performed at participating Japanese institutions between 2010 and 2020. This study used colonoscopy data of fecal immunochemistry test-positive individuals aged ≥ 20 years from three facilities that entered the timing of previous colonoscopies into the endoscopy database. Histologically confirmed advanced neoplasia was the study's primary outcome. Multivariate logistic regression analysis was used to calculate the odds ratios for each variable.
In total, 11,143 fecal immunochemistry test-positive patients underwent colonoscopy during the study period. Of these, 10,160 patients were included in the analysis after excluding those who met the exclusion criteria. The overall advanced neoplasia detection rate was 9.38% (953/10,160; 95% confidence interval: 8.82-9.96%). Compared with the first colonoscopy, the odds ratios for advanced neoplasia in individuals who underwent colonoscopies 1, 2, 3, 4, 5, > 5, and ≥ 10 years previously were 0.27, 0.15, 0.06, 0.10, 0.29, 0.31, and 0.31, respectively.
The detection rates of advanced neoplasia were low among the fecal immunochemistry test-positive individuals who had undergone colonoscopy, particularly in the past 5 years.
既往接受过结肠镜检查的粪便免疫化学检测呈阳性个体患结直肠癌的风险尚不清楚。因此，本研究旨在根据既往结肠镜检查的时间，确定粪便免疫化学检测呈阳性个体患结直肠癌风险的差异。
本多中心、回顾性、观察性研究在日本进行，作为J-SCOUT研究（UMIN000040690）的亚组分析，该研究整合并分析了一个数据库，该数据库包含2010年至2020年期间在参与研究的日本机构进行的所有结肠镜检查。本研究使用了来自三个机构的年龄≥20岁的粪便免疫化学检测呈阳性个体的结肠镜检查数据，这些机构将既往结肠镜检查的时间录入了内镜数据库。组织学确诊的高级别瘤变是本研究的主要结局。采用多因素逻辑回归分析计算各变量的比值比。
在研究期间，共有11143名粪便免疫化学检测呈阳性的患者接受了结肠镜检查。其中，排除符合排除标准的患者后，10160名患者纳入分析。总体高级别瘤变检出率为9.38%（953/10160；95%置信区间：8.82-9.96%）。与首次结肠镜检查相比，既往1、2、3、4、5、>5和≥10年接受结肠镜检查的个体发生高级别瘤变的比值比分别为0.27、0.15、0.06、0.10、0.29、0.31和0.31。
接受过结肠镜检查的粪便免疫化学检测呈阳性个体中，高级别瘤变的检出率较低，尤其是在过去5年中。
