Increased time to colonoscopy after an abnormal fecal occult blood test (FOBT) or fecal immunochemical test (FIT) is associated with an increased risk for colorectal cancer (CRC) incidence and mortality, according to a study published in Gastroenterology. Researchers performed a retrospective cohort study of veterans aged 50-75 with an abnormal FOBT or FIT between 1999 and 2010 to examine the association between the time to colonoscopy and CRC outcomes. CRC-specific incidence and mortality hazard ratios were generated for 3-month colonoscopy intervals with 1-3 months as the reference group. Data were included for a cohort of 204,733 patients (mean age, 61 years). The researchers found an increased risk for CRC for patients who received a colonoscopy at 13-15 months, 16-18 months, 19-21 months, and 22-24 months compared with 1-3 months (hazard ratios [95% confidence intervals], 1.13 [1.00 to 1.27], 1.25 [1.10 to 1.43], 1.28 [1.11 to 1.48], and 1.26 [1.07 to 1.47], respectively). Mortality risk was higher among patients who received a colonoscopy at 19-21 months and 22-24 months compared with those who received a colonoscopy at 1-3 months (hazard ratios [95% confidence intervals], 1.52 [1.51 to 1.99] and 1.39 [1.03 to 1.88], respectively). At 16 months, the investigators observed an increase in the odds for late-stage CRC.
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