Adherence to colonoscopy at 1 year following resection of localized colon cancer: a retrospective cohort study.

Abstract

BACKGROUND:

For patients with stages I-III colon cancer who have undergone surgical resection, guidelines recommend surveillance colonoscopy at 1 year. However, limited data exist on adherence and associated factors. We aimed to determine the rate of adherence to surveillance colonoscopy at 1 year among nonmetastatic colon cancer patients who underwent resection and factors associated with adherence.

METHODS:

In this population-based retrospective cohort study, the Surveillance, Epidemiology, and End Results (SEER)-Medicare database was used. We identified patients with stages I-III colon cancer who underwent surgical resection and survived >3 years without recurrence (no chemotherapy after 8 months) from 2002-2011. Our primary outcome was a colonoscopy claim 10-15 months after resection. We used multivariable regression analysis to assess associations between sociodemographic and clinical factors and receipt of timely colonoscopy.

RESULTS:

Among 28,732 patients who survived >3 years without recurrence, 7967 (28%) did not undergo colonoscopy; 12,033 (42%) had it at one year, with 3159 (11%) before 10 months and 5573 (19%) after 15 months. Decreased adherence was associated with older age; being male versus female; being black or Hispanic versus white; higher tumor stage; left-sided tumors versus right sided; and increased comorbidities. Chemotherapy receipt was associated with increased adherence (odds ratio 2.06; 95% confidence interval 1.88-2.24).

CONCLUSIONS:

In a large population-based sample of individuals aged ⩾ 65 years, only 42% of colon cancer survivors underwent 1-year surveillance colonoscopy. Demographic and clinical factors were associated with adherence.

• Authors: Alfred I Neugut, Xiaobo Zhong, Benjamin Lebwohl, Grace C Hillyer, Melissa K Accordino, Jason D Wright, Ravi P Kiran, Dawn L Hershman
• Journal: Therapeutic advances in gastroenterology (Therap Adv Gastroenterol) Vol. 11 Pg. 1756284818765920 ( 2018) ISSN: 1756-283X [Print] England
• PMID: 35154382 (Publication Type: Journal Article)
• Copyright: © The Author(s), 2018.