Skip to main content

Table 2 Long-term distal colorectal cancer incidence by patient factors and endoscopist variables

From: The impact of endoscopist performance and patient factors on distal adenoma detection and colorectal cancer incidence

 

All eligible participants: Full dataset analysis (n = 34 139)

Participants with complete data on all variables: Complete-case analysis (n = 19 294)a,b

n (%)c

Number of distal CRCs, n

Incidence rate per 100,000 person-years (95% CI)

Univariable HR (95%CI)

p-value

n (%)c

Number of distal CRCs, n

Incidence rate per 100,000 person-years (95% CI)

Univariable HR (95%CI)

p-value

Multivariable HR (95%CI)d

p-value

Total

34 139 (100)

168

31.4 (27.0–36.5)

  

19 294 (100)

91

30.8 (25.1–37.9)

    

Age (IQR), years

60.3 (57.9–62.8)

168

-

1.03 (0.98–1.09)

0.23

60.5 (58.0–62.9)

91

-

1.00 (0.93–1.08)

0.98

1.00 (0.93–1.08)

0.96

Sex

34 139 (100)

168

  

0.003

    

0.06

 

0.12

 Male

18 127 (53.1)

106

38.1 (31.5–46.1)

1

 

10 294 (53.4)

56

36.2 (27.9–47.1)

1

 

1

 

 Female

16 012 (46.9)

62

24.1 (18.8–31.0)

0.62 (0.45–0.85)

 

9 000 (46.7)

35

24.9 (17.9–34.7)

0.67 (0.44–1.03)

 

0.71 (0.45–1.09)

 

Family history of CRC

32 356 (94.8)

156

  

0.026

    

0.23

 

0.24

 No

28 663 (88.6)

129

28.8 (24.2–34.2)

1

 

17 087 (88.6)

77

29.4 (23.5–36.8)

1

 

1

 

 Yes

3 693 (11.4)

27

47.1 (32.3–68.7)

1.65 (1.09–2.50)

 

2 207 (11.4)

14

42.0 (24.9–70.9)

1.44 (0.81–2.54)

 

1.43 (0.81–2.52)

 

Bowel preparation quality

33 609 (98.4)

164

  

0.19

    

0.45

 

0.16

 Excellent

14 573 (43.4)

62

26.8 (20.9–34.4)

1

 

7 819 (40.5)

33

27.4 (19.5–38.5)

1

 

1

 

 Good

11 692 (34.8)

56

30.7 (23.6–39.9)

1.15 (0.80–1.65)

 

6 922 (35.9)

32

30.3 (21.4–42.9)

1.11 (0.69–1.81)

 

1.24 (0.76–2.03)

 

 Adequate

7 060 (21.0)

44

40.5 (30.1–54.4)

1.53 (1.04–2.25)

 

4 553 (23.6)

26

37.8 (25.7–55.5)

1.40 (0.83–2.33)

 

1.72 (0.99–2.97)

 

 Poorb

284 (0.8)

2

44.8 (11.2–178.9)

1.65 (0.40–6.74)

 

-

-

-

-

 

-

 

Insertion time

20 371 (59.7)

93

  

0.53

    

0.42

 

0.20

  < 2.00 mins

7 357 (36.1)

31

27.6 (19.4–39.2)

1

 

7 006 (36.3)

30

28.0 (19.6–40.1)

1

 

1

 

 2.00–2.59 mins

6 198 (30.4)

27

28.5 (19.5–41.6)

1.03 (0.62–1.73)

 

5 885 (30.5)

27

30.0 (20.6–43.7)

1.07 (0.63–1.79)

 

1.09 (0.64–1.84)

 

 3.00–3.59 mins

3 412 (16.7)

14

26.7 (15.8–45.1)

0.96 (0.51–1.81)

 

3 216 (16.7)

13

26.3 (15.3–45.3)

0.93 (0.49–1.79)

 

0.95 (0.49–1.86)

 

 \(\ge\) 4.00 mins

3 404 (16.7)

21

40.6 (26.5–62.3)

1.47 (0.84–2.55)

 

3 187 (16.5)

21

43.3 (28.2–66.4)

1.54 (0.88–2.69)

 

1.81 (1.00–3.27)

 

Withdrawal time

20 326 (59.5)

93

  

0.24

    

0.27

 

0.09

  < 2.00 mins

10 625 (52.3)

42

25.8 (19.1–34.9)

1

 

10 190 (52.8)

42

26.9 (19.9–36.4)

1

 

1

 

 2.00–2.59 mins

3 672 (18.1)

15

26.5 (16.0–44.0)

1.02 (0.56–1.83)

 

3 469 (18.0)

15

28.1 (16.9–46.6)

1.03 (0.57–1.86)

 

1.00 (0.55–1.82)

 

 3.00–3.59 mins

1 837 (9.0)

9

32.0 (16.7–61.5)

1.23 (0.60–2.52)

 

1 738 (9.0)

8

30.1 (15.1–60.2)

1.11 (0.52–2.36)

 

1.19 (0.55–2.57)

 

 \(\ge\) 4.00 mins

4 192 (20.6)

27

42.7 (29.3–62.3)

1.64 (1.01–2.67)

 

3 897 (20.2)

26

44.2 (30.1–64.9)

1.63 (1.00–2.66)

 

1.93 (1.14–3.24)

 

Segment reached

34 075 (99.8)

167

  

0.50

    

0.42

 

0.45

 RM/RS/SC/SD

7 638 (22.4)

36

30.0 (21.7–41.7)

1

 

4 484 (23.2)

18

26.2 (16.5–41.6)

1

 

1

 

 DC

21 327 (62.6)

111

33.2 (27.6–40.0)

1.11 (0.76–1.61)

 

11 822 (61.3)

62

34.2 (26.7–43.9)

1.30 (0.77–2.20)

 

0.99 (0.57–1.71)

 

 SF/TC/HF/AC/CM/TI

5 110 (15.0)

20

25.1 (16.2–39.0)

0.84 (0.49–1.46)

 

2 988 (15.5)

11

24.3 (13.5–43.9)

0.93 (0.44–1.98)

 

0.67 (0.31–1.44)

 

Patient pain

33 323 (97.6)

163

  

0.25

    

0.49

 

0.81

 None

9 563 (28.7)

55

36.7 (28.2–47.9)

1

 

4 929 (25.5)

28

37.4 (25.8–54.1)

1

 

1

 

 Mild

17 859 (53.6)

85

30.4 (24.6–37.6)

0.83 (0.59–1.16)

 

10 541 (54.6)

47

29.1 (21.9–38.8)

0.78 (0.49–1.24)

 

0.87 (0.54–1.40)

 

 Quite a lot/severee

5 901 (17.7)

23

24.8 (16.5–37.3)

0.68 (0.42–1.10)

 

3 824 (19.8)

16

27.2 (16.7–44.4)

0.73 (0.39–1.34)

 

0.83 (0.44–1.58)

 

FS occurrencef

34 139 (100)

168

  

0.18

-

-

 

-

  

-

 First group 500

5 410 (15.8)

35

39.8 (28.5–55.4)

1

 

-

-

-

-

-

-

 

 Later groups 500

28 729 (84.2)

133

29.8 (25.1–35.3)

0.77 (0.53–1.12)

 

-

-

-

-

-

-

 

Endoscopist’s ADR ranking group

34 139 (100)

168

  

0.001

    

 < 0.001

 

 < 0.001

 High

12 929 (37.9)

44

21.8 (16.2–29.3)

1

 

8 161 (42.3)

22

17.5 (11.5–26.6)

1

 

1

 

 Intermediate

10 554 (30.9)

51

30.9 (23.5–40.7)

1.42 (0.95–2.13)

 

6 626 (34.3)

32

31.5 (22.3–44.5)

1.81 (1.05–3.12)

 

2.16 (1.22–3.81)

 

 Low

10 656 (31.2)

73

43.5 (34.6–54.7)

1.99 (1.37–2.90)

 

4 507 (23.4)

37

54.8 (39.7–75.6)

3.24 (1.91–5.49)

 

4.71 (2.65–8.38)

 
  1. Abbreviations: AC ascending colon, ADR adenoma detection rate, CI confidence interval, CM caecum, CRC colorectal cancer, DC descending colon, FS flexible sigmoidoscopy, HF hepatic flexure, HR hazard ratio, Mins minutes, RM rectum, RS recto sigmoid, SC sigmoid colon, SD sigmoid descending, SF splenic flexure, TC transverse colon, TI terminal ileum
  2. P-values were calculated with the likelihood ratio test
  3. a1 783 missing values on family history; 530 missing values on bowel preparation quality; 13 768 missing values on insertion time; 13 813 missing values on withdrawal time; 64 missing values on segment reached; 816 missing values on patient-reported pain (these values are not mutually exclusive)
  4. bParticipants with the ‘poor’ category of bowel preparation quality (n = 39) were excluded from the complete-case analyses due to a lack of cases
  5. cAll n and percentage except the entry for age, which is median and interquartile range
  6. dMultivariable model includes age, sex, family history of CRC, bowel preparation quality, insertion time, withdrawal time, segment reached, patient-reported pain and endoscopist’s ADR ranking group
  7. eParticipants with the ‘severe’ category of patient-reported pain were combined with the category ‘quite a lot’ due to a lack of cases
  8. fOrder of occurrence of FS examination was omitted from the complete-case analyses due to a lack of recorded information for the variables of insertion and withdrawal time for the category ‘first group 500’; this information was not required until partway through the trial at which time each endoscopist had already completed 500 examinations
Back to article page

BMC Gastroenterology

ISSN: 1471-230X

Contact us