PMID- 12837710 OWN - NLM STAT- MEDLINE DCOM- 20030709 LR - 20220310 IS - 1538-3598 (Electronic) IS - 0098-7484 (Linking) VI - 290 IP - 1 DP - 2003 Jul 2 TI - Results of repeat sigmoidoscopy 3 years after a negative examination. PG - 41-8 AB - CONTEXT: The necessary frequency of endoscopic colorectal cancer screening after a negative examination is uncertain. OBJECTIVE: To examine the yield of adenomas and cancer in the distal colon found by repeat flexible sigmoidoscopy (FSG) 3 years after a negative examination. DESIGN, SETTING, AND PARTICIPANTS: Participants were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), a randomized, controlled community-based study of cancer screening. The mean (SD) age was 65.7 (4.0) years at study entry (1993-1995) and 61.6% were men. Individuals underwent screening FSG at baseline and at 3 years as part of the protocol and were referred to their personal physicians for further evaluation of screen-detected abnormalities. Results from subsequent diagnostic evaluations were tracked in a standardized fashion. Of 11 583 eligible for repeat screening FSG 3 years after an initial negative examination, 9317 (80.4%) returned. MAIN OUTCOME MEASURES: Polyp or mass detection in distal colon at year 3 repeat FSG; incidence of adenoma or cancer in distal colon at year 3 examination; determination of reason for detection (increased depth of insertion or improved preparation at the year 3 examination or detection in a previously examined area). RESULTS: A total of 1292 returning participants (13.9%) had a polyp or mass detected by FSG 3 years after the initial examination. In the distal colon, 3.1% (292/9317) were found to have an adenoma or cancer. The incidence of advanced adenoma (n = 72) or cancer (n = 6) in the distal colon was 78 (0.8%) of 9317. Of individuals with advanced distal adenomas detected at the year 3 examination, 80.6% (58/72) had lesions found in a portion of the colon that had been adequately examined at the initial sigmoidoscopy. CONCLUSIONS: Repeat FSG 3 years after a negative examination will detect advanced adenomas and distal colon cancer. Although the overall percentage with detected abnormalities is modest, these data raise concern about the impact of a prolonged screening interval after a negative examination. FAU - Schoen, Robert E AU - Schoen RE AD - Department of Medicine, University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, PA, USA. rschoen@pitt.edu FAU - Pinsky, Paul F AU - Pinsky PF FAU - Weissfeld, Joel L AU - Weissfeld JL FAU - Bresalier, Robert S AU - Bresalier RS FAU - Church, Timothy AU - Church T FAU - Prorok, Philip AU - Prorok P FAU - Gohagan, John K AU - Gohagan JK CN - Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Group LA - eng GR - N01-CN2551/CN/NCI NIH HHS/United States PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - JAMA JT - JAMA JID - 7501160 SB - IM CIN - JAMA. 2003 Jul 2;290(1):106-8. PMID: 12837719 CIN - JAMA. 2003 Oct 22;290(16):2122-3; author reply 2123. PMID: 14570940 CIN - JAMA. 2003 Oct 22;290(16):2122; author reply 2123. PMID: 14570941 CIN - JAMA. 2003 Oct 22;290(16):2123; author reply 2123. PMID: 14570943 MH - Adenoma/*diagnosis/epidemiology MH - Aged MH - Colonic Neoplasms/*diagnosis/epidemiology MH - Colonic Polyps/diagnosis MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Logistic Models MH - Male MH - Middle Aged MH - Randomized Controlled Trials as Topic MH - *Sigmoidoscopy MH - Time Factors EDAT- 2003/07/03 05:00 MHDA- 2003/07/10 05:00 CRDT- 2003/07/03 05:00 PHST- 2003/07/03 05:00 [pubmed] PHST- 2003/07/10 05:00 [medline] PHST- 2003/07/03 05:00 [entrez] AID - 290/1/41 [pii] AID - 10.1001/jama.290.16.2123-b [doi] PST - ppublish SO - JAMA. 2003 Jul 2;290(1):41-8. doi: 10.1001/jama.290.16.2123-b.