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dc.contributor.authorDoubeni, Chyke A.
dc.contributor.authorWeinmann, Sheila
dc.contributor.authorAdams, Kenneth
dc.contributor.authorKamineni, Aruna
dc.contributor.authorBuist, Diana S. M.
dc.contributor.authorAsh, Arlene S.
dc.contributor.authorRutter, Carolyn M.
dc.contributor.authorDoria-Rose, V. Paul
dc.contributor.authorCorley, Douglas A.
dc.contributor.authorGreenlee, Robert T.
dc.contributor.authorChubak, Jessica
dc.contributor.authorWilliams, Andrew E.
dc.contributor.authorKroll-Desrosiers, Aimee
dc.contributor.authorJohnson, Eric
dc.contributor.authorWebster, Joseph
dc.contributor.authorRichert-Boe, Kathryn
dc.contributor.authorLevin, Theodore R.
dc.contributor.authorFletcher, Robert H.
dc.contributor.authorWeiss, Noel S.
dc.date2022-08-11T08:10:34.000
dc.date.accessioned2022-08-23T17:12:57Z
dc.date.available2022-08-23T17:12:57Z
dc.date.issued2013-03-05
dc.date.submitted2013-04-10
dc.identifier.citationAnn Intern Med. 2013;158(5_Part_1):312-320. doi:10.7326/0003-4819-158-5-201303050-00003. <a href="http://dx.doi.org/10.7326/0003-4819-158-5-201303050-00003" target="_blank">Link to article on publisher's site</a>
dc.identifier.issn0003-4819 (Linking)
dc.identifier.doi10.7326/0003-4819-158-5-201303050-00003
dc.identifier.pmid23460054
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46618
dc.description.abstractBACKGROUND: The effectiveness of screening colonoscopy in average-risk adults is uncertain, particularly for right colon cancer. OBJECTIVE: To examine the association between screening colonoscopy and risk for incident late-stage colorectal cancer (CRC). DESIGN: Nested case-control study. SETTING: Four U.S. health plans. PATIENTS: 1039 average-risk adults enrolled for at least 5 years in one of the health plans. Case patients were aged 55 to 85 years on their diagnosis date (reference date) of stage IIB or higher (late-stage) CRC during 2006 to 2008. One or 2 control patients were selected for each case patient, matched on birth year, sex, health plan, and prior enrollment duration. MEASUREMENTS: Receipt of CRC screening 3 months to 10 years before the reference date, ascertained through medical record audits. Case patients and control patients were compared on receipt of screening colonoscopy or sigmoidoscopy by using conditional logistic regression that accounted for health history, socioeconomic status, and other screening exposures. RESULTS: In analyses restricted to 471 eligible case patients and their 509 matched control patients, 13 case patients (2.8%) and 46 control patients (9.0%) had undergone screening colonoscopy, which corresponded to an adjusted odds ratio (AOR) of 0.29 (95% CI, 0.15 to 0.58) for any late-stage CRC, 0.36 (CI, 0.16 to 0.80) for right colon cancer, and 0.26 (CI, 0.06 to 1.11; P = 0.069) for left colon/rectum cancer. Ninety-two case patients (19.5%) and 173 control patients (34.0%) had screening sigmoidoscopy, corresponding to an AOR of 0.50 (CI, 0.36 to 0.70) overall, 0.79 (CI, 0.51 to 1.23) for right colon late-stage cancer, and 0.26 (CI, 0.14 to 0.48) for left colon cancer. LIMITATION: The small number of screening colonoscopies affected the precision of the estimates. CONCLUSION: Screening with colonoscopy in average-risk persons was associated with reduced risk for diagnosis of incident late-stage CRC, including right-sided colon cancer. For sigmoidoscopy, this association was seen for left CRC, but the association for right colon late-stage cancer was not statistically significant. PRIMARY FUNDING SOURCE: National Cancer Institute of the National Institutes of Health.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=23460054&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23460054/
dc.subjectColonoscopy
dc.subjectColorectal Neoplasms
dc.subjectEarly Detection of Cancer
dc.subjectMass Screening
dc.subjectCommunity Health and Preventive Medicine
dc.subjectEpidemiology
dc.subjectNeoplasms
dc.subjectOncology
dc.titleScreening colonoscopy and risk for incident late-stage colorectal cancer diagnosis in average-risk adults: a nested case-control study
dc.typeJournal Article
dc.source.journaltitleAnnals of internal medicine
dc.source.volume158
dc.source.issue5 Pt 1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1080
dc.identifier.contextkey4020083
html.description.abstract<p>BACKGROUND: The effectiveness of screening colonoscopy in average-risk adults is uncertain, particularly for right colon cancer.</p> <p>OBJECTIVE: To examine the association between screening colonoscopy and risk for incident late-stage colorectal cancer (CRC).</p> <p>DESIGN: Nested case-control study.</p> <p>SETTING: Four U.S. health plans.</p> <p>PATIENTS: 1039 average-risk adults enrolled for at least 5 years in one of the health plans. Case patients were aged 55 to 85 years on their diagnosis date (reference date) of stage IIB or higher (late-stage) CRC during 2006 to 2008. One or 2 control patients were selected for each case patient, matched on birth year, sex, health plan, and prior enrollment duration.</p> <p>MEASUREMENTS: Receipt of CRC screening 3 months to 10 years before the reference date, ascertained through medical record audits. Case patients and control patients were compared on receipt of screening colonoscopy or sigmoidoscopy by using conditional logistic regression that accounted for health history, socioeconomic status, and other screening exposures.</p> <p>RESULTS: In analyses restricted to 471 eligible case patients and their 509 matched control patients, 13 case patients (2.8%) and 46 control patients (9.0%) had undergone screening colonoscopy, which corresponded to an adjusted odds ratio (AOR) of 0.29 (95% CI, 0.15 to 0.58) for any late-stage CRC, 0.36 (CI, 0.16 to 0.80) for right colon cancer, and 0.26 (CI, 0.06 to 1.11; P = 0.069) for left colon/rectum cancer. Ninety-two case patients (19.5%) and 173 control patients (34.0%) had screening sigmoidoscopy, corresponding to an AOR of 0.50 (CI, 0.36 to 0.70) overall, 0.79 (CI, 0.51 to 1.23) for right colon late-stage cancer, and 0.26 (CI, 0.14 to 0.48) for left colon cancer. LIMITATION: The small number of screening colonoscopies affected the precision of the estimates.</p> <p>CONCLUSION: Screening with colonoscopy in average-risk persons was associated with reduced risk for diagnosis of incident late-stage CRC, including right-sided colon cancer. For sigmoidoscopy, this association was seen for left CRC, but the association for right colon late-stage cancer was not statistically significant.</p> <p>PRIMARY FUNDING SOURCE: National Cancer Institute of the National Institutes of Health.</p>
dc.identifier.submissionpathqhs_pp/1080
dc.contributor.departmentMeyers Primary Care Institute
dc.contributor.departmentDepartment of Family Medicine and Community Health
dc.contributor.departmentDepartment of Pathology
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages312-20


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