Sahar Pakneshan, Naomi Moy, Ayesha Shah, Natasha Koloski, Mike P Jones, Nicholas J Talley, Gerald Holtmann
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All patients with a diagnosis of UGI cancer within 3 years post-colonoscopy were identified by linking with the Queensland Cancer Register. This was used to compare to the geographical population aged 50-74 years based on the Australian Bureau of Statistics and Queensland Cancer Council data.</p><p><strong>Results: </strong>From 1748 eligible participants, 0.23% (95% confidence interval [CI] 0.06-0.58) were diagnosed with UGI cancer within 3 years post-colonoscopy. This indicates an esophageal cancers rate of 114.42 per 100 000 (95% CI 100.56-298.28) and gastric cancer rate of 57.21 per 100 000 (95% CI 55.76-261.12). Of the patients with a UGI cancer, 75% would have had an unexplained iFOBT. Annual incidence for the same geographic region, ages, and period for the combined esophageal and gastric cancer was 36.08 per 100 000 (95% CI 32.87-39.52).</p><p><strong>Conclusions: </strong>Among individuals with a positive iFOBT in a bowel cancer screening program, the rates of gastric and esophageal cancers were 2.7 and 7.5 times higher than the general population. Adding gastroscopy to a colonoscopy for iFOBT-positive patients in cancer surveillance programs may be justifiable.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Post-colonoscopy upper gastrointestinal malignancies in positive immunochemical fecal occult blood test patients: An Australian data linkage study.\",\"authors\":\"Sahar Pakneshan, Naomi Moy, Ayesha Shah, Natasha Koloski, Mike P Jones, Nicholas J Talley, Gerald Holtmann\",\"doi\":\"10.1111/jgh.16799\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aim: </strong>In immunochemical fecal occult blood test (iFOBT) positive subjects, colonoscopy screening can detect colorectal cancers and advanced adenomas, yet most iFOBT-positive subjects find no relevant lower gastrointestinal lesions. Limited data are available on upper gastrointestinal (UGI) cancer risk in iFOBT-positive patients. This study investigated the incidence of UGI malignancies diagnosed within 3 years post-colonoscopy after a positive iFOBT.</p><p><strong>Methods: </strong>Retrospective analysis of iFOBT-positive patients aged 50-75 years who underwent a colonoscopy at a single institution. All patients with a diagnosis of UGI cancer within 3 years post-colonoscopy were identified by linking with the Queensland Cancer Register. This was used to compare to the geographical population aged 50-74 years based on the Australian Bureau of Statistics and Queensland Cancer Council data.</p><p><strong>Results: </strong>From 1748 eligible participants, 0.23% (95% confidence interval [CI] 0.06-0.58) were diagnosed with UGI cancer within 3 years post-colonoscopy. This indicates an esophageal cancers rate of 114.42 per 100 000 (95% CI 100.56-298.28) and gastric cancer rate of 57.21 per 100 000 (95% CI 55.76-261.12). Of the patients with a UGI cancer, 75% would have had an unexplained iFOBT. Annual incidence for the same geographic region, ages, and period for the combined esophageal and gastric cancer was 36.08 per 100 000 (95% CI 32.87-39.52).</p><p><strong>Conclusions: </strong>Among individuals with a positive iFOBT in a bowel cancer screening program, the rates of gastric and esophageal cancers were 2.7 and 7.5 times higher than the general population. Adding gastroscopy to a colonoscopy for iFOBT-positive patients in cancer surveillance programs may be justifiable.</p>\",\"PeriodicalId\":15877,\"journal\":{\"name\":\"Journal of Gastroenterology and Hepatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-11-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Gastroenterology and Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jgh.16799\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jgh.16799","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的:在免疫化学粪便潜血试验(iFOBT)阳性的受检者中,结肠镜筛查可发现结直肠癌和晚期腺瘤,但大多数 iFOBT 阳性受检者未发现相关的下消化道病变。有关 iFOBT 阳性患者患上消化道癌症风险的数据有限。本研究调查了 iFOBT 阳性后 3 年内经结肠镜检查确诊的上消化道恶性肿瘤的发病率:方法:对在一家机构接受结肠镜检查的 50-75 岁 iFOBT 阳性患者进行回顾性分析。所有在结肠镜检查后 3 年内被诊断出患有上消化道癌的患者均通过与昆士兰癌症登记册进行链接来确定。根据澳大利亚统计局(Australian Bureau of Statistics)和昆士兰癌症委员会(Queensland Cancer Council)的数据,将这些数据与 50-74 岁的地域人口进行比较:结果:在 1748 名符合条件的参与者中,0.23%(95% 置信区间 [CI] 0.06-0.58)的人在结肠镜检查后 3 年内被诊断出患有上消化道癌。这表明食管癌的发病率为每 10 万人 114.42 例(95% CI 100.56-298.28),胃癌的发病率为每 10 万人 57.21 例(95% CI 55.76-261.12)。在患有上消化道癌的患者中,75%的患者会出现不明原因的iFOBT。在相同的地理区域、年龄和时期,食管癌和胃癌的年发病率为每 10 万人 36.08 例(95% CI 32.87-39.52):在肠癌筛查项目中,iFOBT呈阳性的人群中,胃癌和食管癌的发病率分别是普通人群的2.7倍和7.5倍。在癌症监测项目中,对iFOBT阳性患者在进行结肠镜检查的同时进行胃镜检查可能是合理的。
Post-colonoscopy upper gastrointestinal malignancies in positive immunochemical fecal occult blood test patients: An Australian data linkage study.
Background and aim: In immunochemical fecal occult blood test (iFOBT) positive subjects, colonoscopy screening can detect colorectal cancers and advanced adenomas, yet most iFOBT-positive subjects find no relevant lower gastrointestinal lesions. Limited data are available on upper gastrointestinal (UGI) cancer risk in iFOBT-positive patients. This study investigated the incidence of UGI malignancies diagnosed within 3 years post-colonoscopy after a positive iFOBT.
Methods: Retrospective analysis of iFOBT-positive patients aged 50-75 years who underwent a colonoscopy at a single institution. All patients with a diagnosis of UGI cancer within 3 years post-colonoscopy were identified by linking with the Queensland Cancer Register. This was used to compare to the geographical population aged 50-74 years based on the Australian Bureau of Statistics and Queensland Cancer Council data.
Results: From 1748 eligible participants, 0.23% (95% confidence interval [CI] 0.06-0.58) were diagnosed with UGI cancer within 3 years post-colonoscopy. This indicates an esophageal cancers rate of 114.42 per 100 000 (95% CI 100.56-298.28) and gastric cancer rate of 57.21 per 100 000 (95% CI 55.76-261.12). Of the patients with a UGI cancer, 75% would have had an unexplained iFOBT. Annual incidence for the same geographic region, ages, and period for the combined esophageal and gastric cancer was 36.08 per 100 000 (95% CI 32.87-39.52).
Conclusions: Among individuals with a positive iFOBT in a bowel cancer screening program, the rates of gastric and esophageal cancers were 2.7 and 7.5 times higher than the general population. Adding gastroscopy to a colonoscopy for iFOBT-positive patients in cancer surveillance programs may be justifiable.
期刊介绍:
Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.