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Article: Epidemiology, characteristics and survival of post‐colonoscopy colorectal cancer in Asia: a population‐based study

TitleEpidemiology, characteristics and survival of post‐colonoscopy colorectal cancer in Asia: a population‐based study
Authors
Issue Date2019
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH
Citation
Journal of Gastroenterology and Hepatology, 2019, Epub of 2019 How to Cite?
AbstractBACKGROUND AND AIMS: Population-based studies on post-colonoscopy colorectal cancer (CRC) from Asia are sparse. We aimed to determine the characteristics and predictive factors and survival of post-colonoscopy CRC in Hong Kong. METHODS: This is a territory-wide retrospective cohort study. Patients aged ≥40 years with colonoscopies performed between 2005 and 2013 without history of CRCs, inflammatory bowel disease and prior colectomy were included. Post-colonoscopy colorectal cancer for an interval of 3 years (PCCRC-3y) was defined as CRC diagnosed between 6 and 36 months after index colonoscopy, whereas CRC diagnosed within 6 months of index colonoscopy was regarded as 'detected CRC'. We used multivariable logistic regression to derive adjusted odds ratio (aOR) of PCCRC-3y, and Cox model for adjusted hazard ratio (aHR) of cancer-specific mortality after CRC diagnosis. RESULTS: Of the 197,902 eligible patients, 10,005 (92.1%) were detected CRC and 854 (7.9%) PCCRC-3y. The median age at PCCRC-3y diagnosis was 75.9 years (IQR: 65.5-83.8) - a delay of 1.2 years (IQR:0.8-1.9) from index colonoscopy, and 60.1% were male. Predictive factors for PCCRC-3y included older age (aOR:1.07), male sex (aOR:1.45), history of colonic polyps (aOR:1.31), polypectomy/biopsy at index colonoscopy (aOR:3.97), surgical endoscopists (aOR:1.53) and a higher center annual endoscopy volume. Independent predictive factors for cancer-specific mortality after CRC diagnosis included PCCRC-3y (aHR:1.32), proximal cancer location (aHR:1.80) and certain patient factors. CONCLUSION: The PCCRC-3y rate was 7.9% in Hong Kong, with a high proportion (>80%) of distal cancers and a higher cancer-specific mortality compared to detected CRC.
Persistent Identifierhttp://hdl.handle.net/10722/269552
ISSN
2017 Impact Factor: 3.483
2015 SCImago Journal Rankings: 1.190

 

DC FieldValueLanguage
dc.contributor.authorCheung, KSM-
dc.contributor.authorChen, L-
dc.contributor.authorSeto, WKW-
dc.contributor.authorLeung, WK-
dc.date.accessioned2019-04-24T08:10:02Z-
dc.date.available2019-04-24T08:10:02Z-
dc.date.issued2019-
dc.identifier.citationJournal of Gastroenterology and Hepatology, 2019, Epub of 2019-
dc.identifier.issn0815-9319-
dc.identifier.urihttp://hdl.handle.net/10722/269552-
dc.description.abstractBACKGROUND AND AIMS: Population-based studies on post-colonoscopy colorectal cancer (CRC) from Asia are sparse. We aimed to determine the characteristics and predictive factors and survival of post-colonoscopy CRC in Hong Kong. METHODS: This is a territory-wide retrospective cohort study. Patients aged ≥40 years with colonoscopies performed between 2005 and 2013 without history of CRCs, inflammatory bowel disease and prior colectomy were included. Post-colonoscopy colorectal cancer for an interval of 3 years (PCCRC-3y) was defined as CRC diagnosed between 6 and 36 months after index colonoscopy, whereas CRC diagnosed within 6 months of index colonoscopy was regarded as 'detected CRC'. We used multivariable logistic regression to derive adjusted odds ratio (aOR) of PCCRC-3y, and Cox model for adjusted hazard ratio (aHR) of cancer-specific mortality after CRC diagnosis. RESULTS: Of the 197,902 eligible patients, 10,005 (92.1%) were detected CRC and 854 (7.9%) PCCRC-3y. The median age at PCCRC-3y diagnosis was 75.9 years (IQR: 65.5-83.8) - a delay of 1.2 years (IQR:0.8-1.9) from index colonoscopy, and 60.1% were male. Predictive factors for PCCRC-3y included older age (aOR:1.07), male sex (aOR:1.45), history of colonic polyps (aOR:1.31), polypectomy/biopsy at index colonoscopy (aOR:3.97), surgical endoscopists (aOR:1.53) and a higher center annual endoscopy volume. Independent predictive factors for cancer-specific mortality after CRC diagnosis included PCCRC-3y (aHR:1.32), proximal cancer location (aHR:1.80) and certain patient factors. CONCLUSION: The PCCRC-3y rate was 7.9% in Hong Kong, with a high proportion (>80%) of distal cancers and a higher cancer-specific mortality compared to detected CRC.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH-
dc.relation.ispartofJournal of Gastroenterology and Hepatology-
dc.rightsThis is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.titleEpidemiology, characteristics and survival of post‐colonoscopy colorectal cancer in Asia: a population‐based study-
dc.typeArticle-
dc.identifier.emailCheung, KSM: cks634@hku.hk-
dc.identifier.emailChen, L: equalclj@hku.hk-
dc.identifier.emailSeto, WKW: wkseto@hku.hk-
dc.identifier.emailLeung, WK: waikleung@hku.hk-
dc.identifier.authorityCheung, KSM=rp02532-
dc.identifier.authoritySeto, WKW=rp01659-
dc.identifier.authorityLeung, WK=rp01479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/jgh.14674-
dc.identifier.hkuros297524-
dc.identifier.volumeEpub of 2019-
dc.publisher.placeAustralia-

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