Follow-Up Colonoscopy Screening for Colorectal Cancer Finally Gets a Time Stamp

Positive test results from the initial step of colorectal screening may need a quicker follow-up colonoscopy than many people are getting.

A common at-home screening method called the fecal immunochemical test (FIT) gives people the opportunity to find early signs of colon cancer. Positive test results mean that the person needs a follow-up colonoscopy for further evaluation. But how long can someone wait before the colonoscopy? Currently, there are no guidelines addressing the time period, but researchers at Kaiser Permanente conducted a study that could finally put a time stamp on it. The data is set to be presented at Digestive Disease Week (DDW) 2016 in San Diego, California on May 21.

“Little is known about the consequences of differences in time to the diagnostic follow-up on patient outcomes,” the authors wrote. “Therefore, we evaluated variation in time to colonoscopy follow-up and risk colorectal cancer-related outcomes.”

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The team looked at 82,887 people in California, ages 50 to 75, with positive FIT tests. The time it took to go from results to follow-up colonoscopy were separated and evaluated.

• 31 to 60 days
• 61 to 90 days
• 91 to 180 days
• 181 to 364 days
• 365 days or more

The researchers also analyzed the participants’ risks of colorectal cancer, including by stage. The multivariate logistic regression results were adjusted for sex, age, race, body mass index (BMI), comorbidities, and FIT screening years.

The median time from FIT test to colonoscopy was 37 days. A total of 64.1% of participants had a colonoscopy within 60 days and 83.4% had one within one year. But does the number of days even matter? According to this study, the answer is yes.

The patients who waiting for longer than one year had increases in almost every colorectal cancer-related outcomes including advanced colorectal cancer stages II, III, and IV.

“These findings support efforts to perform timely diagnostic follow-up within six months of a positive fecal test,” the team concluded.

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