- Follow-up of high-risk adenomas detected after a fecal occult blood test (FOBT) reduces colorectal cancer (CRC) risk to that of the general population.
Why this matters
- The study is the first to assess long-term CRC incidence in individuals diagnosed with adenoma after FOBT.
- Population-based cohort study in 2 Danish counties (2005-2006); n=80,563; reference population, n=1,240,348.
- Funding: None disclosed.
- 1924 (2.4%) had positive FOBT, of whom 37% were found to have adenomas.
- Based on European guidelines for quality assurance in CRC screening and diagnosis, 47% of adenoma patients were in the intermediate-risk group, 23% low risk, and 30% high risk.
- CRC incidence:
- Patients with adenoma: 322 (95% CI, 212-489) cases per 100,000 person-years.
- Reference population: 244 (95% CI, 242-247) cases per 100,000 person-years.
- High-risk adenomas found after a positive FOBT were associated with higher CRC risk than the reference population (aHR, 1.80; 95% CI, 1.00-3.26).
- High-risk adenomas with no follow-up were associated with a higher CRC risk compared with the reference population (aHR, 3.34; 95% CI, 1.67-6.69).
- Patients with high-risk adenoma who underwent follow-up colonoscopy had a similar risk to the reference population.