Delaying colonoscopy after positive stool-based screening test increases CRC rates, study finds

Patients must confirm a positive stool-based colorectal cancer screening test with a colonoscopy, and delaying that follow-up colonoscopy has led to increased CRC rates, according to a study published in Gastroenterology Feb. 2.

Researchers performed a retrospective cohort study on 204,733 veterans with abnormal fecal occult blood tests or fecal immunochemical tests.

All patients received a follow-up colonoscopy. Patients who waited 13 to 15 months, 16 to 18 months, 19 to 21 months or 22 to 24 months for a follow-up colonoscopy had an increased risk of CRC compared to patients who received a colonoscopy at one to three months.

Mortality risk was highest in groups who received a colonoscopy after 19 months or more, and patients who waited 16 months or more faced increased odds for late-stage CRC.

Researchers concluded, "Increased time to colonoscopy is associated with higher risk of CRC incidence, death, and late stage CRC after abnormal FIT/FOBT. Interventions to improve CRC outcomes should emphasize diagnostic follow-up within 1 year of an abnormal FIT/FOBT result."

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