CRC mortality more than doubles among colonoscopy non-compliers
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Patients who did not comply with colonoscopy, compared with compliers, had more than double the rate of cumulative colorectal cancer mortality during 10 years of follow-up in an organized program, according to study results.
“The excess risk of CRC death among those not completing colonoscopy after a positive fecal occult blood test should prompt screening programs to adopt effective interventions to increase compliance in this high-risk population,” Manuel Zorzi, MD, MSc, from Veneto the Tumor Registry, Azienda Zero, Padova, Italy, and colleagues wrote.
Researchers from the fecal immunological test-based CRC screening program identified patients aged 50 to 69 years with a positive FIT result and invited patients to receive a diagnostic colonoscopy. Investigators reported 88,013 patients who were FIT-positive complied with colonoscopy (men, 56.1%; aged 50–59 years, 49.1%) while 23,410 did not (men, 54.6%; aged 50–59 years, 44.9%).
Zorzi and colleagues used the Kaplan-Meier estimator and Cox-Aalen models to compare the 10-year cumulative CRC incidence and mortality among FIT-positive patients who completed a diagnostic coloscopy within the program and non-compliers.
“The 10-year cumulative incidence of CRC was 44.7 per 1,000 (95% CI, 43.1-46.3) among colonoscopy compliers and 54.3 per 1,000 (95% CI, 49.9-58.7) in non-compliers, while the cumulative mortality for CRC was 6.8 per 1,000 (95% CI, 5.9-7.6) and 16 per 1,000 (95% CI, 13.1-18.9), respectively,” Zorzi and colleagues wrote.
According to researchers, the risk for dying of CRC among non-compliers was 103% higher compared with the risk among compliers (adjusted HR = 2.03; 95% CI, 1.68-2.44).
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