Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study
Monitoring complications of colonoscopies after a positive faecal immunochemical test (FIT-colonoscopies) is crucial in FIT-based colorectal cancer (CRC) screening. We investigated the occurrence of bleeding and perforation post FIT-colonoscopies (2013–2019) in Flanders and the contributing factors....
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Gastrointestinal Disorders |
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| Online Access: | https://www.mdpi.com/2624-5647/6/1/3 |
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| author | Thuy Ngan Tran Joanna Bouchat Marc Peeters Bea Berghmans Eric Van Cutsem Guido Van Hal Koen Van Herck Sarah Hoeck |
| author_facet | Thuy Ngan Tran Joanna Bouchat Marc Peeters Bea Berghmans Eric Van Cutsem Guido Van Hal Koen Van Herck Sarah Hoeck |
| author_sort | Thuy Ngan Tran |
| collection | DOAJ |
| description | Monitoring complications of colonoscopies after a positive faecal immunochemical test (FIT-colonoscopies) is crucial in FIT-based colorectal cancer (CRC) screening. We investigated the occurrence of bleeding and perforation post FIT-colonoscopies (2013–2019) in Flanders and the contributing factors. A retrospective case–control study was conducted, including bleeding/perforation cases within 14 days after index colonoscopy, and controls without such events. Bleeding rates dropped from 0.9–1.1% (pre-2017) to 0.3% (2017–2018) and further to 0.05% (2019), while perforation rates remained at 0.05–0.11% (2014–2019). Male gender, polypectomy, general anaesthesia, and recent antiplatelet/antithrombotic drug use increased bleeding odds. Incomplete colonoscopy, polypectomy, general anaesthesia, and recent antiplatelet/antithrombotic drug use raised perforation odds. The endoscopists (n = 16) with highest bleeding rates (top 5%) performed only 6% of total FIT-colonoscopies, yet their patients experienced 45.5% of bleeding events. Similarly, for the top 5% of perforation rates, endoscopists conducting only 4.5% of total FIT-colonoscopy had 49.0% of perforation events occur in their patients. This study sheds light on FIT-colonoscopy-related complications in Flanders, their rates and risk factors. These findings can be incorporated into CRC screening materials and guide interventions to mitigate complications. A central colonoscopy register is currently lacking in Belgium, highlighting the need for its establishment to facilitate recurrent monitoring and evaluation. |
| first_indexed | 2024-04-24T18:15:34Z |
| format | Article |
| id | doaj.art-37b93e946b1846488ee0b4440d923440 |
| institution | Directory Open Access Journal |
| issn | 2624-5647 |
| language | English |
| last_indexed | 2024-04-24T18:15:34Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Gastrointestinal Disorders |
| spelling | doaj.art-37b93e946b1846488ee0b4440d9234402024-03-27T13:42:30ZengMDPI AGGastrointestinal Disorders2624-56472024-01-0161264810.3390/gidisord6010003Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control StudyThuy Ngan Tran0Joanna Bouchat1Marc Peeters2Bea Berghmans3Eric Van Cutsem4Guido Van Hal5Koen Van Herck6Sarah Hoeck7Centre for Cancer Detection, 8000 Bruges, BelgiumBelgian Cancer Registry, 1210 Brussels, BelgiumDepartment of Oncology, Antwerp University Hospital, 2650 Antwerp, BelgiumDepartment of Gastro-Enterology, A.S.Z. Aalst Hospital, 9300 Aalst, BelgiumDigestive Oncology, University Hospitals Gasthuisberg, 3000 Leuven, BelgiumCentre for Cancer Detection, 8000 Bruges, BelgiumBelgian Cancer Registry, 1210 Brussels, BelgiumCentre for Cancer Detection, 8000 Bruges, BelgiumMonitoring complications of colonoscopies after a positive faecal immunochemical test (FIT-colonoscopies) is crucial in FIT-based colorectal cancer (CRC) screening. We investigated the occurrence of bleeding and perforation post FIT-colonoscopies (2013–2019) in Flanders and the contributing factors. A retrospective case–control study was conducted, including bleeding/perforation cases within 14 days after index colonoscopy, and controls without such events. Bleeding rates dropped from 0.9–1.1% (pre-2017) to 0.3% (2017–2018) and further to 0.05% (2019), while perforation rates remained at 0.05–0.11% (2014–2019). Male gender, polypectomy, general anaesthesia, and recent antiplatelet/antithrombotic drug use increased bleeding odds. Incomplete colonoscopy, polypectomy, general anaesthesia, and recent antiplatelet/antithrombotic drug use raised perforation odds. The endoscopists (n = 16) with highest bleeding rates (top 5%) performed only 6% of total FIT-colonoscopies, yet their patients experienced 45.5% of bleeding events. Similarly, for the top 5% of perforation rates, endoscopists conducting only 4.5% of total FIT-colonoscopy had 49.0% of perforation events occur in their patients. This study sheds light on FIT-colonoscopy-related complications in Flanders, their rates and risk factors. These findings can be incorporated into CRC screening materials and guide interventions to mitigate complications. A central colonoscopy register is currently lacking in Belgium, highlighting the need for its establishment to facilitate recurrent monitoring and evaluation.https://www.mdpi.com/2624-5647/6/1/3colonoscopycomplicationsbleedingperforationcolorectal cancer screeningFlanders |
| spellingShingle | Thuy Ngan Tran Joanna Bouchat Marc Peeters Bea Berghmans Eric Van Cutsem Guido Van Hal Koen Van Herck Sarah Hoeck Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study Gastrointestinal Disorders colonoscopy complications bleeding perforation colorectal cancer screening Flanders |
| title | Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study |
| title_full | Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study |
| title_fullStr | Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study |
| title_full_unstemmed | Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study |
| title_short | Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study |
| title_sort | bleeding and perforation complications after follow up colonoscopies in faecal immunochemical test based colorectal cancer screening insights from a retrospective case control study |
| topic | colonoscopy complications bleeding perforation colorectal cancer screening Flanders |
| url | https://www.mdpi.com/2624-5647/6/1/3 |
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