Baseline adenoma feature | Odds ratio (95% CI) |
---|---|
2 adenomas vs 1 adenoma | |
3 adenomas vs 1 adenoma | |
4 adenomas vs 1 adenoma | |
Proximal vs distal | |
5–9 mm vs <5 mm | |
10–19 mm vs <5 mm | |
Tubulovillous/villous vs tubular |
Birth to 49 years, % | 50–59 years, % | 60–69 years, % | 70 years and older, % | Birth to death, % | |
---|---|---|---|---|---|
Male | 0.3 (1 in 300) | 0.7 (1 in 149) | 1.2 (1 in 82) | 3.7 (1 in 27) | 4.7 (1 in 21) |
Female | 0.3 (1 in 318) | 0.5 (1 in 195) | 0.9 (1 in 117) | 3.4 (1 in 30) | 4.4 (1 in 23) |
Risk factor | Relative risk (95% CI) |
---|---|
Alcohol: heavy (140–257 g/week) vs non-drinker | |
Obesity: BMI ≥30 vs ≤25 | |
Smoking: current vs never smoker | |
Diabetes | |
Red meat consumption (100 g/day increase) | |
Processed meat consumption (50 g/day increase) |
Method | Screening Interval |
---|---|
High sensitivity gFOBT or FIT | |
Stool DNA | |
Computed tomography colonography | |
Flexible sigmoidoscopy | |
Colonoscopy |
Study | No. of participants | Age, y | Design | Median follow-up, y | Results |
---|---|---|---|---|---|
Atkin 201035 (UK) | 170,432 (170,038 in analysis) |
55–64
|
Offered FS vs no contact |
11.2
|
Incidence reduced by 23% and mortality by 31% in group offered FS |
Segnan 201136 (Italy) | 34,292 (34,272 in analysis) |
55–64
|
Offered FS vs no contact |
10.2
|
Incidence reduced by 18% and mortality by 22% in group offered FS |
Schoen 201237 (U.S.) | 154,900 |
55–74
|
FS at baseline and 3 or 5 years later vs usual care |
11.9 years
|
Incidence reduced by 21% and mortality by 26% in FS group+ |
Holme 201138 (Norway) | 100,210 (98,792 in analysis) |
50–64
|
FS or FS and FOBT vs no intervention |
7 years
|
Incidence reduced by 36% and mortality by 31% |
Quality metric | Goal |
---|---|
Cecal intubation rate | ≥95% |
Adenoma detection rate | 25% Females ≥ Males ≥ |
Performed to published standards and indication documented | >80% |
Inadequate bowel preparation | <15% |
Average withdrawal time (negative results) | ≥6 minutes |
Risk condition | Start screening | Screening interval |
---|---|---|
CRC or advanced adenomaa diagnosed in a 1st–degree relative <60 years old, OR two 1st–degree relatives of any age | The earlier of: age 40 or 10 years before the age the relative was diagnosed with CRC or advanced adenoma | 5 years |
A 1st–degree relative ≥60 years old with CRC or advanced adenoma | Age 50 | 10 years |
Lynch syndrome (confirmed mutation) | Age 20–25 | 2 years (age <40); 1 year (age ≥40) |
Lynch–like syndrome or familial colorectal type | Age 20–25 | 1–2 years |
FAP, AFAP, or MAP | Puberty | 1–2 years (1 year with established polyps) |
Cancer | Test | Surveillance interval |
---|---|---|
Colorectal cancer | Colonoscopy | At years 1, 3, and 5 following diagnosis. Every 5 years thereafter if normal, more frequently pending findings |
Rectal cancer* | Endoscopic ultrasound or flexible sigmoidoscopy | Every 3–6 months for 2–3 years |