Highlights
- •Prevalence of neoplasia at repeat CTC after a negative baseline exam was assessed.
- •3 masses were detected in 3/636 participants (0.47%) at a mean 4.6-year interval.
- •52 neoplasia ≥6 mm were found in 7.4% of participants, with/without risk factors.
- •This supports recommendations for a 5-year interval after negative baseline CTC.
Abstract
Aim
Assess the prevalence of neoplasia ≥6 mm at repeat CT colonoscopy (CTC) in individuals
with no significant lesions at baseline.
Methods
Individuals aged ≥18 years, with/without CRC risk factors, with no polyps ≥6 mm on
baseline CTC (negative baseline) who underwent repeat CTC in a large HMO from 2001
to 2011 were retrospectively identified. Studies were reviewed by board-certified
radiologists with experience interpreting CTC. Demographic details, CRC risk factors,
and the number, size, and location of incident lesions were noted. Findings were classified
using the C-RADS scale. Lesion prevalence at CTC-2 was determined, and study interval
and risk characteristics of patients with- and without findings were compared.
Results
Our study included 636 individuals (369 men [58.0%]; mean age 59.9 years) with negative
baseline CTC who underwent repeat CTC after a mean 4.6 year interval (SD 1.6 years).
At baseline, 469/636 (73.7%) were at average risk for CRC; 418 remained at average
risk for CTC-2 with 51 (8.0%) developing new risk factors in the interval between
studies. At CTC-2, 47 participants (7.4%) presented 52 significant neoplasia: 35 polyps
6–9 mm, 14 polyps ≥10 mm, and 3 masses in 3/636 participants (0.47%). 2/3 masses,
6/14 polyps ≥10 mm (42.9%), and 12/25 polyps 6–9 mm (48.0%) were in individuals with
risk factors for CRC. Histopathology was available for 12/52 lesions (23.1%): 8 tubular
adenomas, 2 villous adenomas, 1 hamartomatous polyp, 1 case of normal tissue.
Conclusion
A mean 4.6 years after negative-baseline CTC, neoplasia ≥6 mm were seen in 7.4% of
participants, including masses in 0.47%, supporting recommendations for a 5-year study
interval.
Keywords
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Article info
Publication history
Published online: January 20, 2019
Accepted:
January 15,
2019
Received in revised form:
January 14,
2019
Received:
November 25,
2018
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
