Retrospective Cohort Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2018; 24(8): 905-916
Published online Feb 28, 2018. doi: 10.3748/wjg.v24.i8.905
Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
Mohamad A Mouchli, Lidia Ouk, Marianne R Scheitel, Alisha P Chaudhry, Donna Felmlee-Devine, Diane E Grill, Shahrooz Rashtak, Panwen Wang, Junwen Wang, Rajeev Chaudhry, Thomas C Smyrk, Ann L Oberg, Brooke R Druliner, Lisa A Boardman
Mohamad A Mouchli, Lidia Ouk, Donna Felmlee-Devine, Shahrooz Rashtak, Brooke R Druliner, Lisa A Boardman, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
Marianne R Scheitel, Knowledge and Delivery Center, Mayo Clinic, Rochester, MN 55905, United States
Alisha P Chaudhry, Biostatistics and Bioinformatics, Health Sciences Research, Mayo Clinic, Rochester, MN 55905, United States
Diane E Grill, Ann L Oberg, Division of Biomedical Statistics and Informatics, Health Sciences Research, Mayo Clinic, Rochester, MN 55905, United States
Panwen Wang, Junwen Wang, Biostatistics and Bioinformatics, Health Science Research, Center for Individualized Medicine Mayo Clinic, Scottsdale, AZ 85259, United States
Junwen Wang, Department of Biomedical Informatics, Arizona State University, Scottsdale, AZ 85259, United States
Rajeev Chaudhry, Primary Care Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
Rajeev Chaudhry, Center for Innovation, Mayo Clinic, Rochester, MN 55905, United States
Thomas C Smyrk, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Boardman LA developed study design; Mouchli MA, Grill DE and Boardman LA participated in the writing of the paper and did the statistical analysis; Mouchli MA, Ouk L, Scheitel MS, Chaudhry AP, Felmlee-Devine D and Boardman LA reviewed medical records and data; Basu N, Ouk L, Scheitel MS, Chaudhry AP, Aletto Felmlee-Devine D, Rashtak S, Wang P, Wang J, Chaudhry R, Smyrk TC, Oberg AL and Druliner BR edited the manuscript.
Supported by the National Cancer Institute, No. CA170357; and the Mayo Clinic Center for Cell Signaling in Gastroenterology, NIDDK Mo. P30DK084567.
Institutional review board statement: Two IRB approved protocols were used for this study including IRB 622-00 which had original approval date of April 4, 2000 and IRB 12-000182 which was approved on February 1, 2012.
Informed consent statement: The Mayo Clinic IRB Reviewer approved waver of informed consent and HIPAA authorization in accordance with applicable regulations for data collected under IRB 622-00.
Conflict-of-interest statement: There are no conflicts of interest to report for any of the authors.
Data sharing statement: We plan to share research resources and materials taking into account the NIH Grant Policy on Sharing of Unique Research Resources, including the Sharing of Biomedical Research Resources Principles and Guidelines for recipients of NIH Grants and Contracts issued in December 1999. In preparing human data for data-sharing, we will de-identify human phenotypic data to ensure that the identities of research subjects cannot be readily ascertained. We will strip the data of identifiers according to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Lisa A Boardman, MD, Full Professor, Staff Physician, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
Telephone: +1-507-2664338 Fax: +1-507-2660350
Received: August 3, 2017
Peer-review started: August 5, 2017
First decision: August 30, 2017
Revised: November 17, 2017
Accepted: December 5, 2017
Article in press: December 5, 2017
Published online: February 28, 2018
Core Tip

Core tip: Screening colonoscopy reduces colorectal cancer morbidity and mortality risks through detection and treatment of precursor lesions. However, screening colonoscopy has a 3.5% false negative rate for detection of colorectal cancer (CRC) resulting in 17% of patients who had undergone colon screening within 3 years being diagnosed with CRC. We report that 3% of patients with advanced polyps in a surveillance program developed interval CRC. Recognition that CRC could develop following advanced polyp removal despite adherence to guidelines is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality.