Colonoscopy-Related Adverse Events in Patients With Abnormal Stool-Based Tests: A Systematic Review of Literature and Meta-analysis of Outcomes.
Journal
The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030
Informations de publication
Date de publication:
01 03 2022
01 03 2022
Historique:
received:
05
03
2021
accepted:
27
12
2021
pubmed:
15
1
2022
medline:
29
4
2022
entrez:
14
1
2022
Statut:
ppublish
Résumé
Colorectal cancer (CRC) screening programs based on the fecal immunochemical test (FIT) and guaiac-based fecal occult blood (gFOBT) are associated with a substantial reduction in CRC incidence and mortality. We conducted a systematic review and comprehensive meta-analysis to evaluate colonoscopy-related adverse events in individuals with a positive FIT or gFOBT. A systematic and detailed search was run in January 2021, with the assistance of a medical librarian for studies reporting on colonoscopy-related adverse events as part of organized CRC screening programs. Meta-analysis was performed using the random-effects model, and the results were expressed for pooled proportions along with relevant 95% confidence intervals (CIs). A total of 771,730 colonoscopies were performed in patients undergoing CRC screening using either gFOBT or FIT across 31 studies. The overall pooled incidence of severe adverse events in the entire patient cohort was 0.42% (CI 0.20-0.64); I2 = 38.76%. In patients with abnormal gFOBT, the incidence was 0.2% (CI 0.1-0.3); I2 = 24.6%, and in patients with a positive FIT, it was 0.4% (CI 0.2-0.7); I2 = 48.89%. The overall pooled incidence of perforation, bleeding, and death was 0.13% (CI 0.09-0.21); I2 = 22.84%, 0.3% (CI 0.2-0.4); I2 = 35.58%, and 0.01% (CI 0.00-0.01); I2 = 33.21%, respectively. Our analysis shows that in colonoscopies performed after abnormal stool-based testing, the overall risk of severe adverse events, perforation, bleeding, and death is minimal.
Identifiants
pubmed: 35029161
doi: 10.14309/ajg.0000000000001614
pii: 00000434-202203000-00014
doi:
Substances chimiques
Guaiac
9000-29-7
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
381-393Informations de copyright
Copyright © 2021 by The American College of Gastroenterology.
Références
Zorzi M, Fedeli U, Schievano E, et al. Impact on colorectal cancer mortality of screening programmes based on the faecal immunochemical test. Gut 2015;64:784–90.
Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for colorectal cancer: US Preventive Services Task Force Recommendation statement. JAMA 2016;315:2564–75.
Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med 1993;328:1365–71.
Libby G, Fraser CG, Carey FA, et al. Occult blood in faeces is associated with all-cause and non-colorectal cancer mortality. Gut 2018;67:2116–23.
Towler B, Irwig L, Glasziou P, et al. A systematic review of the effects of screening for colorectal cancer using the faecal occult blood test, hemoccult. BMJ 1998;317:559–65.
Hewitson P, Glasziou P, Watson E, et al. Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): An update. Am J Gastroenterol 2008;103:1541–9.
Ventura L, Mantellini P, Grazzini G, et al. The impact of immunochemical faecal occult blood testing on colorectal cancer incidence. Dig Liver Dis 2014;46:82–6.
Zorzi M, Da Re F, Mantellini P, et al. Screening for colorectal cancer in Italy: 2011-2012 survey. Epidemiol Prev 2015;39:93–107.
Senore C, Basu P, Anttila A, et al. Performance of colorectal cancer screening in the European union member states: Data from the second European screening report. Gut 2019;68:1232–44.
Denis B, Gendre I, Sauleau EA, et al. Harms of colonoscopy in a colorectal cancer screening programme with faecal occult blood test: A population-based cohort study. Dig Liver Dis 2013;45:474–80.
Rutter MD, Nickerson C, Rees CJ, et al. Risk factors for adverse events related to polypectomy in the English Bowel Cancer Screening Programme. Endoscopy 2014;46:90–7.
Kothari ST, Huang RJ, Shaukat A, et al. ASGE review of adverse events in colonoscopy. Gastrointest Endosc 2019;90:863–e33.
Reumkens A, Rondagh EJ, Bakker CM, et al. Post-colonoscopy complications: A systematic review, time trends, and meta-analysis of population-based studies. Am J Gastroenterol 2016;111:1092–101.
San Miguel Y, Demb J, Martinez ME, et al. Time to colonoscopy after abnormal stool-based screening and risk for colorectal cancer incidence and mortality. Gastroenterology 2021;160:1997–2005.e3.
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000;283:2008–12.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: The prisma statement. BMJ 2009;339:b2535–269.
Hoy D, Brooks P, Woolf A, et al. Assessing risk of bias in prevalence studies: Modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 2012;65:934–9.
Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0.: The Cochrane Collaboration, 2011. ( www.cochrane-handbook.org ).
Terracciano L, Brozek J, Compalati E, Schunemann H. GRADE system: new paradigm. Curr Opin Allergy Clin Immunol 2010;10(4):377e83.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986;7:177–88.
Sutton AJ, Abrams KR, Jones DR, et al. Methods for Meta-Analysis in Medical Research. J. Wiley: New York, 2000.
Mohan BP, Adler DG. Heterogeneity in systematic review and meta-analysis: How to read between the numbers. Gastrointest Endosc 2019;89:902–3.
Higgins J, Thompson SG, Spiegelhalter DJ. A re‐evaluation of random‐effects meta‐analysis. J R Stat Soc Ser A 2009;172:137–59.
Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ 2003;327:557–60.
Duval S, Tweedie R. Trim and Fill: A simple funnel-plot–based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000;56:455–63.
Bech K, Kronborg O, Fenger C. Adenomas and hyperplastic polyps in screening studies. World J Surg 1991;15:7–13.
Kewenter J, Brevinge H. Endoscopic and surgical complications of work-up in screening for colorectal cancer. Dis Colon Rectum 1996;39:676–80.
Robinson MH, Hardcastle JD, Moss SM, et al. The risks of screening: Data from the nottingham randomised controlled trial of faecal occult blood screening for colorectal cancer. Gut 1999;45:588–92.
Gondal G, Grotmol T, Hofstad B, et al. The Norwegian colorectal cancer prevention (NORCCAP) screening study: Baseline findings and implementations for clinical work-up in age groups 50-64 years. Scand J Gastroenterol 2003;38:635–42.
Sung JJ, Chan FK, Leung WK, et al. Screening for colorectal cancer in Chinese: Comparison of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. Gastroenterology 2003;124:608–14.
UK Colorectal Cancer Screening Pilot Group. Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom. BMJ 2004;329:133.
Multicentre Australian Colorectal-neoplasia Screening (MACS) Group. A comparison of colorectal neoplasia screening tests: A multicentre community-based study of the impact of consumer choice. Med J Aust 2006;184:546–50.
Ellul P, Fogden E, Simpson CL, et al. Downstaging of colorectal cancer by the national bowel cancer screening programme in England: First round data from the first centre. Colorectal Dis 2010;12:420–2.
Gupta S, Saunders BP, Fraser C, et al. The first 3 years of national bowel cancer screening at a single UK tertiary centre. Colorectal Dis 2012;14:166–73.
Kistler CE, Kirby KA, Lee D, et al. Long-term outcomes following positive fecal occult blood test results in older adults: Benefits and burdens. Arch Intern Med 2011;171:1344–51.
Binefa G, García M, Milà N, et al. Colonoscopy quality assessment in a mass population screening programme based on faecal occult blood test. Rev Esp Enferm Dig 2013;105:400–8.
Saraste D, Martling A, Nilsson PJ, et al. Complications after colonoscopy and surgery in a population-based colorectal cancer screening programme. J Med Screen 2016;23:135–40.
Vanaclocha-Espi M, Ibáñez J, Molina-Barceló A, et al. Risk factors for severe complications of colonoscopy in screening programs. Prev Med 2019;118:304–8.
Denis B, Gendre I, Weber S, et al. Adverse events of colonoscopy in a colorectal cancer screening program with fecal immunochemical testing: A population-based observational study. Endosc Int Open 2021;9:E224–32.
Quyn AJ, Fraser CG, Stanners G, et al. Scottish Bowel Screening Programme colonoscopy quality—scope for improvement? Colorectal Dis 2018;20:O277–83.
Lee TJ, Rutter MD, Blanks RG, et al. Colonoscopy quality measures: Experience from the NHS bowel cancer screening programme. Gut 2012;61:1050–7.
Ibáñez J, Vanaclocha-Espí M, Pérez-Sanz E, et al. Severe complications in colorectal cancer screening colonoscopies in the Valencian Community. Gastroenterol Hepatol 2018;41:553–61.
Arana-Arri E, Imaz-Ayo N, Fernández MJ, et al. Screening colonoscopy and risk of adverse events among individuals undergoing fecal immunochemical testing in a population-based program: A nested case-control study. United Eur Gastroenterol J 2018;6:755–64.
Hsu WF, Chang CY, Chang CC, et al. Risk of colonoscopy-related complications in a fecal immunochemical test-based population colorectal cancer screening program. Endoscopy 2020. doi: 10.1055/a-1328-5126 .
doi: 10.1055/a-1328-5126
Benazzato L, Zorzi M, Antonelli G, et al. Colonoscopy-related adverse events and mortality in an Italian organized colorectal cancer screening program. Endoscopy 2021;53:501–8.
Dancourt V, Lejeune C, Lepage C, et al. Immunochemical faecal occult blood tests are superior to guaiac-based tests for the detection of colorectal neoplasms. Eur J Cancer 2008;44:2254–8.
Zorzi M, Hassan C, Battagello J, et al. Adenoma detection by Endocuff-assisted versus standard colonoscopy in an organized screening program: The “ItaVision” randomized controlled trial. Endoscopy 2021. doi: 10.1055/a-1379-6868 .
doi: 10.1055/a-1379-6868
Parente F, Boemo C, Ardizzoia A, et al. Outcomes and cost evaluation of the first two rounds of a colorectal cancer screening program based on immunochemical fecal occult blood test in northern Italy. Endoscopy 2013;45:27–34.
Hassan C, Senore C, Radaelli F, et al. Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme. Gut 2017;66:1949–55.
Tepeš B, Bracko M, Novak Mlakar D, et al. Results of the FIT-based national colorectal cancer screening program in Slovenia. J Clin Gastroenterol 2017;51:e52–9.
Castells A, Quintero E. Programmatic screening for colorectal cancer: The COLONPREV study. Dig Dis Sci 2015;60:672–80.
Denters MJ, Deutekom M, Essink-Bot ML, et al. FIT false-positives in colorectal cancer screening experience psychological distress up to 6 weeks after colonoscopy. Support Care Cancer 2013;21:2809–15.
Knapp GC, Alatise O, Olopade B, et al. Feasibility and performance of the fecal immunochemical test (FIT) for average-risk colorectal cancer screening in Nigeria. PLoS One 2021;16:e0243587.
Portillo I, Idigoras I, Bilbao I, et al. Colorectal cancer screening program using FIT: Quality of colonoscopy varies according to hospital type. Endosc Int Open 2018;6:E1149–56.
Mikkelsen EM, Thomsen MK, Tybjerg J, et al. Colonoscopy-related complications in a nationwide immunochemical fecal occult blood test-based colorectal cancer screening program. Clin Epidemiol 2018;10:1649–55.
Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy. Gastrointest Endosc 2015;81:31–53.
Rembacken B, Hassan C, Riemann JF, et al. Quality in screening colonoscopy: Position statement of the European Society of Gastrointestinal Endoscopy (ESGE). Endoscopy 2012;44:957–68.
Montminy EM, Zhou M, Maniscalco L, et al. Contributions of adenocarcinoma and carcinoid tumors to Early-onset colorectal cancer incidence rates in the United States. Ann Intern Med 2021;174:157–66.
Davidson KW, Davidson KW, Barry MJ, et al. Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA 2021;325:1965–77.
Wong MCS, Huang J, Lok V, et al. Differences in incidence and mortality trends of colorectal cancer worldwide based on sex, age, and anatomic location. Clin Gastroenterol Hepatol 2021;19:955–66.e961.
Lin JS, Piper MA, Perdue LA, et al. Screening for colorectal cancer: Updated evidence report and systematic review for the US preventive services task force. JAMA 2016;315:2576–94.
Knudsen AB, Zauber AG, Rutter CM, et al. Estimation of benefits, burden, and harms of colorectal cancer screening strategies: Modeling study for the US preventive services task force. JAMA 2016;315:2595–609.
Heavener T, Jaeger V, Stephenson K, et al. Diagnostic Colonoscopy Following Abnormal FIT Results: A Quality Improvement Analysis. American Society of Clinical Oncology. J Clin Oncol 2018;36(4_suppl):568–568
Issaka RB, Singh MH, Oshima SM, et al. Inadequate utilization of diagnostic colonoscopy following abnormal FIT results in an integrated safety-net system. Am J Gastroenterol 2017;112:375–82.
Gupta S, Sussman DA, Doubeni CA, et al. Challenges and possible solutions to colorectal cancer screening for the underserved. J Natl Cancer Inst 2014;106:dju032.
Jetelina KK, Yudkin JS, Miller S, et al. Patient-reported barriers to completing a diagnostic colonoscopy following abnormal fecal immunochemical test among uninsured patients. J Gen Intern Med 2019;34:1730–6.
Chiu SY, Chuang SL, Chen SL, et al. Faecal haemoglobin concentration influences risk prediction of interval cancers resulting from inadequate colonoscopy quality: Analysis of the Taiwanese nationwide colorectal cancer screening program. Gut 2017;66:293–300.
van Doorn SC, Stegeman I, Stroobants AK, et al. Fecal immunochemical testing results and characteristics of colonic lesions. Endoscopy 2015;47:1011–7.
Kooyker AI, Toes-Zoutendijk E, Opstal-van Winden AWJ, et al. Colonoscopy-related mortality in a fecal immunochemical test-based colorectal cancer screening program. Clin Gastroenterol Hepatol 2021;19:1418–25.
Garcia M, Milà N, Binefa G, et al. False-positive results from colorectal cancer screening in Catalonia (Spain), 2000-2010. J Med Screen 2012;19:77–82.
Logan RF, Patnick J, Nickerson C, et al. Outcomes of the bowel cancer screening programme (BCSP) in England after the first 1 million tests. Gut 2012;61:1439–46.