PMID- 33553585
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210210
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 2
DP  - 2021 Feb
TI  - Adverse events of colonoscopy in a colorectal cancer screening program with fecal 
      immunochemical testing: a population-based observational study.
PG  - E224-E232
LID - 10.1055/a-1324-2763 [doi]
AB  - Background and study aims  The aim of this study was to assess adverse events 
      (AEs) associated with colonoscopy in the French colorectal cancer screening 
      program with fecal occult blood test (FOBT). Patients and methods  A 
      retrospective cohort study was performed of all colonoscopies performed from 2015 
      to 2018 for a positive fecal immunochemical test (FIT) in patients aged 50 to 74 
      years within the screening program in progress in Alsace, part of the French 
      program. AEs were recorded through prospective voluntary reporting by community 
      gastroenterologists and retrospective postal surveys addressed to individuals 
      screened. They were compared with those recorded in the previous program 
      following colonoscopies performed from 2003 to 2014 for a positive guaiac-based 
      FOBT (gFOBT). Results  Of 9576 colonoscopies performed for a positive FIT, 6194 
      (64.7 %) were therapeutic. Overall, 180 AEs were recorded (18.8  per thousand, 95 % CI 
      16.1-21.5), 114 of them (11.9  per thousand, 95 % CI 9.7-14.1) requiring hospitalization, 55 
      (5.7 per thousand, 95 % CI 4.2-7.3) hospitalization > 24 hours, and eight (0.8  per thousand, 95 % CI 
      0.3-1.4) surgery. The main complications requiring hospitalization were 
      perforation (n = 18, 1.9  per thousand, 95 % CI 1.0-2.7) and bleeding (n = 31, 3.2  per thousand, 95 % CI 
      2.1-4.4). Despite a significant increase in several risk factors for 
      complication, the rate of AEs remained stable between gFOBT and FIT programs. 
      Overall, we observed one death (1/27,000 colonoscopies) and three splenic 
      injuries. Conclusions  The harms of colonoscopy in a colorectal cancer screening 
      program with FIT are more frequent than usually estimated. This study revealed 
      six AEs requiring hospitalization > 24 hours (three bleeds, two perforations), 
      one necessitating surgery, and 50 minor complications per 1000 colonoscopies.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commecial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Denis, Bernard
AU  - Denis B
AD  - Department of Gastroenterology, Louis Pasteur Hospital, Colmar, France.
AD  - ADECA Alsace, Colmar, France.
FAU - Gendre, Isabelle
AU  - Gendre I
AD  - ADECA Alsace, Colmar, France.
FAU - Weber, Sarah
AU  - Weber S
AD  - ADECA Alsace, Colmar, France.
FAU - Perrin, Philippe
AU  - Perrin P
AD  - ADECA Alsace, Colmar, France.
LA  - eng
PT  - Journal Article
DEP - 20210203
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7857960
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2021/02/09 06:00
MHDA- 2021/02/09 06:01
PMCR- 2021/02/01
CRDT- 2021/02/08 05:51
PHST- 2020/06/27 00:00 [received]
PHST- 2020/10/22 00:00 [accepted]
PHST- 2021/02/08 05:51 [entrez]
PHST- 2021/02/09 06:00 [pubmed]
PHST- 2021/02/09 06:01 [medline]
PHST- 2021/02/01 00:00 [pmc-release]
AID - 10.1055/a-1324-2763 [doi]
PST - ppublish
SO  - Endosc Int Open. 2021 Feb;9(2):E224-E232. doi: 10.1055/a-1324-2763. Epub 2021 Feb 
      3.