Incidence of interval colorectal cancer: A tertiary hospital report

Abstract

Colorectal cancer (CRC) remains the leading cause of death in Taiwan despite mandatory CRC screening programs for early detection. The development of CRC between periods of follow-up remains a Taiwanese health and economic burden. This study aimed to investigate the relationship between consequent progression of polyps and interval CRC and identify potential risk factors. This retrospective chart review study reviewed 1671 CRC patients between 1 January 2002 and 31 December 2018, in Kaohsiung Chang Gung Memorial Hospital for interval CRC analysis. Interval CRC is defined as CRC diagnosed within 5 years after a negative colonoscopy. We further analyzed potential risk factors associated with interval CRC such as sex, age, underlying disease, and previous pathologic type of polyps by univariate and multivariate analyses. A total of 44 patients developed interval CRC in this study (2.63%). Ten patients were from the proctologist division and five from the gastroenterology department. Mean diagnostic interval was 919.45 ± 547.78 days in male and 897.87 ± 586.14 days in female patients. Multivariate analysis showed that right-side colon polyp demonstrated independent risk factors for interval CRC development in our observation (P < .001; hazard ratio (HR), 3.897; 95% confidence interval (CI), 1.934-7.780). In conclusion, interval CRC prevalence in a cohort is 2.63%. Location of polyps over the right colon is relevant to interval CRC occurrence.