Document Type : Research Articles
Authors
1
Department of Gastroenterology and Haematology, Hirosaki University Graduate School of Medicine 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
2
Department of Medical Informatics, Hirosaki University Hospital, 53 Honcho, Hirosaki, Aomori 036- 8563, Japan.
3
Clinical Research Support Centre, Hirosaki University Hospital, 53 Honcho, Hirosaki, Aomori 036-8563, Japan.
4
Department of Gastroenterology and Hematology, Hirosaki National Hospital, 1 Tomino-cho, Hirosaki, Aomori 036-8545, Japan.
5
Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036- 8562, Japan.
6
Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1 Omori-Nishi, Ota-ku, Japan.
7
TF Clinic, Ginza M&S building 7F, 4-13-11 Ginza, Chuo-ku, Tokyo 104-0061, Japan.
8
Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
9
Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.
10
Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
11
Department of Gastroenterology, Aomori Prefectural Central Hospital, 2-1-1, Higashi-Tsukurimichi, Aomori 030-8553, Japan.
12
Aomori Prefectural Central Hospital, 2-1-1, Higashi-Tsukurimichi, Aomori 030-8553, Japan.
Abstract
Objective: To improve the efficacy of colorectal cancer (CRC) screening, decreasing the occurrence of interval cancers is essential. Most interval CRCs develop from fecal immunochemical test (FIT)-negative CRC. This study examined the clinical characteristics of FIT-negative advanced neoplasms (AN) and sessile serrated lesions (SSL), which are main candidate precursors of FIT-negative CRC, and the eligibility criteria for total colonoscopy (TCS) screening following negative FIT. Methods: Asymptomatic participants in their 50s were divided into two groups. The FIT-negative group underwent TCS following negative FIT, and the TCS-only group underwent TCS without FIT. One endoscopist reviewed the endoscopic images. Plausible risk factors for colorectal polyps were extracted. The clinical features of AN and SSL were compared between the groups. Result: Of 2,437 participants, 56.2% were included in the FIT-negative group. No between-group differences were recorded for the prevalence of different colorectal polyp types. By multivariate analysis, a significantly lower adjusted odds ratio (AOR) of AN was shown in women, and significantly higher AORs of AN were found for aging, smoking, and a family history of CRC. The AOR of SSL was higher for smokers. The proportion of AN in the right colon was higher in the FIT-negative group. No between-group differences were recorded for SSL. Conclusion: FIT screening was less likely to detect CRC and certain precancerous lesions in the right colon. Combining annual FIT with TCS for the high-risk population based on a scoring system, may detect FIT-negative CRC and colorectal polyps, thus, reducing interval cancer.
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