Colonoscopy intervals may be extended beyond 10 years for people at low CRC risk

Negative colonoscopy screening findings appear to be associated with lower colorectal cancer (CRC) incidence and mortality for 20 years, and as such, rescreening intervals may be extended beyond the currently recommended 10 years for people with a low-risk profile, according to a study.

Researchers looked at three prospective US population–based cohorts from the Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study. Risk profile distribution was compared with that of the participants from the National Health and Nutrition Examination Survey (NHANES) 2017–2018 cycle.

The analysis included a total of 195,453 participants (median age 44 years, 81 percent female). Over a median follow-up of 12 years, 394 and 2,220 CRC cases were documented among 81,151 individuals with negative colonoscopy screening results and 114,302 who did not undergo endoscopy, respectively. There were 167 and 637 CRC deaths that occurred in the respective groups.

Cox proportional hazards regression analysis showed that negative colonoscopy screening results were consistently associated with lower CRC incidence (hazard ratio [HR], 0.51, 95 percent confidence interval [CI], 0.44–0.58) and mortality (HR, 0.56, 95 percent CI, 0.46–0.70) for 20 years.

For individuals with negative colonoscopy screening results, the 10-year cumulative CRC incidence among those with an intermediate risk (scores, 6-7) and low risk (scores, 0-5) (0.78 percent) did not reach that observed among high-risk individuals (scores, 8-12) until 16 and 25 years after initial screening, respectively.

The present data underscore the importance of considering known CRC risk factors when making decisions for colonoscopy rescreening.