TY - JOUR
T1 - Colonoscopy-Related Adverse Events in Patients with Abnormal Stool-Based Tests
T2 - A Systematic Review of Literature and Meta-analysis of Outcomes
AU - Chandan, Saurabh
AU - Facciorusso, Antonio
AU - Yarra, Pradeep
AU - Khan, Shahab R.
AU - Ramai, Daryl
AU - Mohan, Babu P.
AU - Kassab, Lena L.
AU - Bilal, Mohammad
AU - Shaukat, Aasma
N1 - Publisher Copyright:
© 2022 Wolters Kluwer Health. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - INTRODUCTION:Colorectal cancer (CRC) screening programs based on the fecal immunochemical test (FIT) and guaiac-based fecal occult blood (gFOBT) are associated with a substantial reduction in CRC incidence and mortality. We conducted a systematic review and comprehensive meta-analysis to evaluate colonoscopy-related adverse events in individuals with a positive FIT or gFOBT.METHODS:A systematic and detailed search was run in January 2021, with the assistance of a medical librarian for studies reporting on colonoscopy-related adverse events as part of organized CRC screening programs. Meta-analysis was performed using the random-effects model, and the results were expressed for pooled proportions along with relevant 95% confidence intervals (CIs).RESULTS:A total of 771,730 colonoscopies were performed in patients undergoing CRC screening using either gFOBT or FIT across 31 studies. The overall pooled incidence of severe adverse events in the entire patient cohort was 0.42% (CI 0.20-0.64); I2= 38.76%. In patients with abnormal gFOBT, the incidence was 0.2% (CI 0.1-0.3); I2= 24.6%, and in patients with a positive FIT, it was 0.4% (CI 0.2-0.7); I2= 48.89%. The overall pooled incidence of perforation, bleeding, and death was 0.13% (CI 0.09-0.21); I2= 22.84%, 0.3% (CI 0.2-0.4); I2= 35.58%, and 0.01% (CI 0.00-0.01); I2= 33.21%, respectively.DISCUSSION:Our analysis shows that in colonoscopies performed after abnormal stool-based testing, the overall risk of severe adverse events, perforation, bleeding, and death is minimal.
AB - INTRODUCTION:Colorectal cancer (CRC) screening programs based on the fecal immunochemical test (FIT) and guaiac-based fecal occult blood (gFOBT) are associated with a substantial reduction in CRC incidence and mortality. We conducted a systematic review and comprehensive meta-analysis to evaluate colonoscopy-related adverse events in individuals with a positive FIT or gFOBT.METHODS:A systematic and detailed search was run in January 2021, with the assistance of a medical librarian for studies reporting on colonoscopy-related adverse events as part of organized CRC screening programs. Meta-analysis was performed using the random-effects model, and the results were expressed for pooled proportions along with relevant 95% confidence intervals (CIs).RESULTS:A total of 771,730 colonoscopies were performed in patients undergoing CRC screening using either gFOBT or FIT across 31 studies. The overall pooled incidence of severe adverse events in the entire patient cohort was 0.42% (CI 0.20-0.64); I2= 38.76%. In patients with abnormal gFOBT, the incidence was 0.2% (CI 0.1-0.3); I2= 24.6%, and in patients with a positive FIT, it was 0.4% (CI 0.2-0.7); I2= 48.89%. The overall pooled incidence of perforation, bleeding, and death was 0.13% (CI 0.09-0.21); I2= 22.84%, 0.3% (CI 0.2-0.4); I2= 35.58%, and 0.01% (CI 0.00-0.01); I2= 33.21%, respectively.DISCUSSION:Our analysis shows that in colonoscopies performed after abnormal stool-based testing, the overall risk of severe adverse events, perforation, bleeding, and death is minimal.
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U2 - 10.14309/ajg.0000000000001614
DO - 10.14309/ajg.0000000000001614
M3 - Review article
C2 - 35029161
AN - SCOPUS:85125682613
VL - 117
SP - 381
EP - 393
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 3
ER -