Original articleColorectal Cancers Found After a Complete Colonoscopy
Section snippets
Patient Selection and Data Collection
All veterans with a diagnosis of cancer at the Minneapolis Veteran Affairs Medical Center are accessioned into a cancer registry and are monitored for lifetime follow-up. The registry currently has data on 34,738 patients with cancer and consistently maintains a >95% follow-up rate. We searched the cancer registry from January 1, 1991 to August 31, 2004, and identified all patients with incident colorectal cancer. We excluded those with familial adenomatous polyposis, hereditary non-polyposis
Results
During the specified period, 830 patients were diagnosed with colorectal cancer at the Minneapolis Veterans Affairs Medical Center and met entry criteria for the study. Of these, 45 patients developed colorectal cancers within 5 years of their most recent colonoscopy. These cancers were termed interval cancers and accounted for 5.4% (95% confidence interval [CI], 4.1%–7.2%) of all colorectal cancers diagnosed at our institution. Interval cancers were diagnosed on average 33.8 months after
Discussion
Of all colorectal cancers diagnosed at our institution, 5.4% developed within 5 years of the complete colonoscopy. Interval cancers were more likely to be located in the right colon and were smaller in size when compared with sporadic cancers. Twenty-seven percent of interval cancers occurred at a previous polypectomy segment, and there was a significant association between the location of polypectomy segments and the subsequent location of interval cancers. Factors that influence the quality
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Supported in part by VA Clinical Science R&D Service (grant no. 04S-CRCOE-001) (M.S.S.).