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Colonoscopy-related complications in a nationwide immunochemical fecal occult blood test-based colorectal cancer screening program

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Colonoscopy-related complications in a nationwide immunochemical fecal occult blood test-based colorectal cancer screening program. / Mikkelsen, Ellen M; Thomsen, Mette Kielsholm; Tybjerg, Julie; Friis-Hansen, Lennart; Andersen, Berit; Jørgensen, Jens Christian Riis; Baatrup, Gunnar; Njor, Sisse H; Mehnert, Frank; Rasmussen, Morten.

In: Clinical epidemiology, Vol. 10, 13.11.2018, p. 1649-1655.

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Mikkelsen, Ellen M ; Thomsen, Mette Kielsholm ; Tybjerg, Julie ; Friis-Hansen, Lennart ; Andersen, Berit ; Jørgensen, Jens Christian Riis ; Baatrup, Gunnar ; Njor, Sisse H ; Mehnert, Frank ; Rasmussen, Morten. / Colonoscopy-related complications in a nationwide immunochemical fecal occult blood test-based colorectal cancer screening program. In: Clinical epidemiology. 2018 ; Vol. 10. pp. 1649-1655.

Bibtex

@article{c87379fb6c1f4f16891bcb0e57413c8a,
title = "Colonoscopy-related complications in a nationwide immunochemical fecal occult blood test-based colorectal cancer screening program",
abstract = "Background: The Danish national screening program for colorectal cancer (CRC) consists of an immunochemical fecal occult blood test (iFOBT) followed by colonoscopy. The Danish Colorectal Cancer Screening Database (DCCSD) records data on the incidence of hospital-registered complications after colonoscopy. However, the validity of these data is unknown, and the incidence of complications is potentially underreported. Objective: To evaluate the validity of the colonoscopy complications registered in the DCCSD by using medical records as the reference. Further, to evaluate the incidence of complications leading to hospital contact. Methods: Among 14,671 individuals with a positive iFOBT result and a colonoscopy procedure performed from March 3, 2014 to December 31, 2014, we selected 295 individuals for medical record review. We calculated sensitivity as the proportion of true complications registered in the DCCSD out of all complications found in the medical records, and the positive predictive value (PPV) as the number of true complications in the DCCSD out of all DCCSD-registered complications. On the basis of the medical record data, we calculated the incidence proportion of hospital-registered complications overall and by subtype. Results: In total, we reviewed 286 records and found 102 individuals with at least one complication. The sensitivity of the DCCSD for any complication was 29.4% (95% CI: 20.8–39.3) and the PPV was 88.2% (95% CI: 72.6–96.7). On the basis of the medical record data, the incidence proportion of any complication after colonoscopy was 0.70% (95% CI: 0.57–0.84) and that of perforation or lesion was 0.10% (95% CI: 0.06–0.17); bleeding, 0.41% (95% CI: 0.31–0.53); post-polypectomy syndrome, 0.16% (95% CI: 0.10–0.24); and other medical complications, 0.04 (95% CI: 0.02–0.09). Conclusion: The DCCSD has low sensitivity for complications, and improvements in data registration are warranted. The incidence proportion of any hospital-treated post-colonoscopy complication was 0.70% in 2014, which was the first year of the Danish national CRC screening program. This is within the range of complications reported by other studies.",
keywords = "Harms, Prevention, Public health",
author = "Mikkelsen, {Ellen M} and Thomsen, {Mette Kielsholm} and Julie Tybjerg and Lennart Friis-Hansen and Berit Andersen and J{\o}rgensen, {Jens Christian Riis} and Gunnar Baatrup and Njor, {Sisse H} and Frank Mehnert and Morten Rasmussen",
year = "2018",
month = nov,
day = "13",
doi = "10.2147/CLEP.S181204",
language = "English",
volume = "10",
pages = "1649--1655",
journal = "Clinical Epidemiology",
issn = "1179-1349",
publisher = "Dove Medical Press Ltd.(Dovepress)",

}

RIS

TY - JOUR

T1 - Colonoscopy-related complications in a nationwide immunochemical fecal occult blood test-based colorectal cancer screening program

AU - Mikkelsen, Ellen M

AU - Thomsen, Mette Kielsholm

AU - Tybjerg, Julie

AU - Friis-Hansen, Lennart

AU - Andersen, Berit

AU - Jørgensen, Jens Christian Riis

AU - Baatrup, Gunnar

AU - Njor, Sisse H

AU - Mehnert, Frank

AU - Rasmussen, Morten

PY - 2018/11/13

Y1 - 2018/11/13

N2 - Background: The Danish national screening program for colorectal cancer (CRC) consists of an immunochemical fecal occult blood test (iFOBT) followed by colonoscopy. The Danish Colorectal Cancer Screening Database (DCCSD) records data on the incidence of hospital-registered complications after colonoscopy. However, the validity of these data is unknown, and the incidence of complications is potentially underreported. Objective: To evaluate the validity of the colonoscopy complications registered in the DCCSD by using medical records as the reference. Further, to evaluate the incidence of complications leading to hospital contact. Methods: Among 14,671 individuals with a positive iFOBT result and a colonoscopy procedure performed from March 3, 2014 to December 31, 2014, we selected 295 individuals for medical record review. We calculated sensitivity as the proportion of true complications registered in the DCCSD out of all complications found in the medical records, and the positive predictive value (PPV) as the number of true complications in the DCCSD out of all DCCSD-registered complications. On the basis of the medical record data, we calculated the incidence proportion of hospital-registered complications overall and by subtype. Results: In total, we reviewed 286 records and found 102 individuals with at least one complication. The sensitivity of the DCCSD for any complication was 29.4% (95% CI: 20.8–39.3) and the PPV was 88.2% (95% CI: 72.6–96.7). On the basis of the medical record data, the incidence proportion of any complication after colonoscopy was 0.70% (95% CI: 0.57–0.84) and that of perforation or lesion was 0.10% (95% CI: 0.06–0.17); bleeding, 0.41% (95% CI: 0.31–0.53); post-polypectomy syndrome, 0.16% (95% CI: 0.10–0.24); and other medical complications, 0.04 (95% CI: 0.02–0.09). Conclusion: The DCCSD has low sensitivity for complications, and improvements in data registration are warranted. The incidence proportion of any hospital-treated post-colonoscopy complication was 0.70% in 2014, which was the first year of the Danish national CRC screening program. This is within the range of complications reported by other studies.

AB - Background: The Danish national screening program for colorectal cancer (CRC) consists of an immunochemical fecal occult blood test (iFOBT) followed by colonoscopy. The Danish Colorectal Cancer Screening Database (DCCSD) records data on the incidence of hospital-registered complications after colonoscopy. However, the validity of these data is unknown, and the incidence of complications is potentially underreported. Objective: To evaluate the validity of the colonoscopy complications registered in the DCCSD by using medical records as the reference. Further, to evaluate the incidence of complications leading to hospital contact. Methods: Among 14,671 individuals with a positive iFOBT result and a colonoscopy procedure performed from March 3, 2014 to December 31, 2014, we selected 295 individuals for medical record review. We calculated sensitivity as the proportion of true complications registered in the DCCSD out of all complications found in the medical records, and the positive predictive value (PPV) as the number of true complications in the DCCSD out of all DCCSD-registered complications. On the basis of the medical record data, we calculated the incidence proportion of hospital-registered complications overall and by subtype. Results: In total, we reviewed 286 records and found 102 individuals with at least one complication. The sensitivity of the DCCSD for any complication was 29.4% (95% CI: 20.8–39.3) and the PPV was 88.2% (95% CI: 72.6–96.7). On the basis of the medical record data, the incidence proportion of any complication after colonoscopy was 0.70% (95% CI: 0.57–0.84) and that of perforation or lesion was 0.10% (95% CI: 0.06–0.17); bleeding, 0.41% (95% CI: 0.31–0.53); post-polypectomy syndrome, 0.16% (95% CI: 0.10–0.24); and other medical complications, 0.04 (95% CI: 0.02–0.09). Conclusion: The DCCSD has low sensitivity for complications, and improvements in data registration are warranted. The incidence proportion of any hospital-treated post-colonoscopy complication was 0.70% in 2014, which was the first year of the Danish national CRC screening program. This is within the range of complications reported by other studies.

KW - Harms

KW - Prevention

KW - Public health

U2 - 10.2147/CLEP.S181204

DO - 10.2147/CLEP.S181204

M3 - Journal article

C2 - 30519113

VL - 10

SP - 1649

EP - 1655

JO - Clinical Epidemiology

JF - Clinical Epidemiology

SN - 1179-1349

ER -