Imperial College London
Portrait Picture

Professor Amanda Cross

Faculty of Medicine, School of Public Health

Professor of Cancer Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 3338amanda.cross

 
 
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Assistant

 

Mr Will Kay +44 (0)20 7594 3350

 
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Location

 

Room 1089Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Robbins:2020:10.1055/a-1217-0155,
author = {Robbins, E and Wooldrage, K and Stenson, I and Pack, K and Duffy, S and Conell, C and Wright, S and Nickerson, C and Martin, J and Cross, A},
doi = {10.1055/a-1217-0155},
journal = {Endoscopy},
pages = {402--410},
title = {Heterogeneity in colorectal cancer incidence among people recommended three-yearly surveillance post-polypectomy: a validation study},
url = {http://dx.doi.org/10.1055/a-1217-0155},
volume = {53},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundColonoscopy surveillance is recommended for patients at increased risk of colorectal cancer (CRC) following adenoma removal. Low-, intermediate-, and high-risk groups are defined by baseline adenoma characteristics. We previously evaluated surveillance in intermediate-risk patients using UK hospital data, identifying a higher-risk subgroup who benefitted from surveillance and a lower-risk subgroup who may not require surveillance. Here we explored whether these findings apply in individuals undergoing CRC screening. MethodsRetrospective study using data from the UK Flexible Sigmoidoscopy Screening Trial (UKFSST), English CRC screening pilot (ECP), and US Kaiser Permanente CRC prevention programme (KPCP). Screening participants aged 50–74 years and classed as intermediate-risk at baseline colonoscopy were included. CRC data were available through 2006 (KPCP) or 2014 (UKFSST, ECP). We classified participants into lower- and higher-risk subgroups using our previously identified baseline risk factors; higher-risk participants were those with incomplete colonoscopies, poor bowel preparation, adenomas ≥20mm or with high-grade dysplasia, or proximal polyps. We compared CRC incidence rates in these subgroups and in the presence versus absence of surveillance using Cox regression.ResultsOf 2291 intermediate-risk participants, 45% were classified as higher-risk. Median follow-up was 11.8 years. CRC incidence rates were significantly higher in the higher-risk than lower-risk subgroup (hazard ratio [HR]=2.08, 95%CI 1.07–4.06). Surveillance reduced CRC incidence rates in higher-risk participants (HR=0.35, 0.14–0.86), but not statistically significantly so in lower-risk participants (HR=0.41, 0.12–1.38).ConclusionAs previously demonstrated for hospital patients, screening participants classed as intermediate-risk comprise two risk subgroups. Surveillance clearly benefits the higher-risk subgroup.
AU  - Robbins,E
AU  - Wooldrage,K
AU  - Stenson,I
AU  - Pack,K
AU  - Duffy,S
AU  - Conell,C
AU  - Wright,S
AU  - Nickerson,C
AU  - Martin,J
AU  - Cross,A
DO  - 10.1055/a-1217-0155
EP  - 410
PY  - 2020///
SN  - 0013-726X
SP  - 402
TI  - Heterogeneity in colorectal cancer incidence among people recommended three-yearly surveillance post-polypectomy: a validation study
T2  - Endoscopy
UR  - http://dx.doi.org/10.1055/a-1217-0155
UR  - http://hdl.handle.net/10044/1/80988
VL  - 53
ER  -
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