caa a22 4500 44579786X CHVBK 20180317145131.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s10620-011-1788-6 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1788-6 Predictors of Colorectal Cancer Following a Negative Colonoscopy in the Medicare Population [Elektronische Daten] [Amanpal Singh, Yong-Fang Kuo, Taylor Riall, G. Raju, James Goodwin] Background: The incidence of colorectal cancer following a normal colonoscopy in the Medicare population is not known. Methods: A 5% national sample of Medicare enrollees from 1996 to 2005 was used to identify patients undergoing complete colonoscopy. A colonoscopy not associated with any procedure (e.g., biopsy, polypectomy or fulguration) was defined as a negative colonoscopy. Patients with history of inflammatory bowel disease, colorectal cancer or death within 12months of colonoscopy were excluded. A multivariable model was constructed to evaluate the factors associated with a new diagnosis of colorectal cancer in the period from 12 to 120months following the negative colonoscopy. Results: Among 200,857 patients (mean age 74years, 61% female, 92% White) with a negative colonoscopy, the incidence of colorectal cancer was 1.8 per 1,000 person-years. The incidence rate for matched follow-up periods decreased from 2.0/1,000 person-years for patients undergoing colonoscopy during 1996-2000 to 1.2/1,000 person years during 2001-2005. Multivariate analysis revealed a significant regional variation in the incidence of colorectal cancer following a negative colonoscopy. The incidence was higher in patients >85years, males and patients who underwent a negative colonoscopy by a non-gastroenterologist or endoscopist in the lowest volume quartile. On stratified analyses, endoscopist volume was a significant predictor for non-gastroenterologists only. Conclusions: The specialty and experience of the endoscopist are significant predictors of the incidence rate of colorectal cancer in Medicare patients with a negative colonoscopy. Springer Science+Business Media, LLC, 2011 Colonoscopy nationallicence Colon cancer nationallicence Missed diagnosis nationallicence Diagnostic errors nationallicence Regional variation nationallicence Singh Amanpal Division of Gastroenterology, Department of Internal Medicine, University of Texas Medical Branch (UTMB), 301 University Blvd., 77555-0764, Galveston, TX, USA aut Kuo Yong-Fang Sealy Center on Aging, University of Texas Medical Branch (UTMB), Galveston, TX, USA aut Riall Taylor Sealy Center on Aging, University of Texas Medical Branch (UTMB), Galveston, TX, USA aut Raju G. Departments of Gastroenterology, Hepatology and Nutrition, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Goodwin James Sealy Center on Aging, University of Texas Medical Branch (UTMB), Galveston, TX, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3122-3128 0163-2116 56:11<3122 2011 56 10620 https://doi.org/10.1007/s10620-011-1788-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1788-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Singh Amanpal Division of Gastroenterology, Department of Internal Medicine, University of Texas Medical Branch (UTMB), 301 University Blvd., 77555-0764, Galveston, TX, USA aut NATIONALLICENCE 700 1- Kuo Yong-Fang Sealy Center on Aging, University of Texas Medical Branch (UTMB), Galveston, TX, USA aut NATIONALLICENCE 700 1- Riall Taylor Sealy Center on Aging, University of Texas Medical Branch (UTMB), Galveston, TX, USA aut NATIONALLICENCE 700 1- Raju G. Departments of Gastroenterology, Hepatology and Nutrition, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Goodwin James Sealy Center on Aging, University of Texas Medical Branch (UTMB), Galveston, TX, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3122-3128 0163-2116 56:11<3122 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer