Unacceptable variation in screening colonoscopy
Ce dossier présente une méta-analyse (28 études) évaluant la prévalence de néoplasies colorectales en fonction du délai entre deux coloscopies, ainsi qu'une étude analysant en Angleterre l'évolution sur la période 2005-2013 du taux de cancer colorectal dans les 3 ans qui suivent un examen coloscopique
Fixing it will require strategic investment in data collection and infrastructureHeisser and colleagues’ (doi:10.1136/bmj.l6109) linked meta-analysis of colorectal cancer and adenoma prevalence in the years following a negative colonoscopy shows that while neoplasms (including adenomas) were observed in more than 20% of participants within five years, advanced neoplasms were rare even after 10 years (2.1% in men, 1.8% in women).1 The authors concluded that a 10 year screening interval after negative colonoscopy, as currently recommended,2 could be adequate.1In a second paper, Burr and colleagues (doi:10.1136/bmj.l6090) quantify rates of colorectal cancer up to three years after a negative colonoscopy in England.3 They report a decreasing incidence of post-colonoscopy cancers over the period of investigation (from 9.0% in 2005 to 6.5% in 2013), but highlight statistically significant variation between colonoscopy providers. Specifically, they find higher rates of post colonoscopy cancers following privately provided colonoscopy, after controlling for certain confounding factors (adjusted odds ratio 1.63 (95% confidence interval 1.39 to 1.91), P<0.01). Rates were also higher among women, older …
BMJ , éditorial en libre accès, 2018