Background and Aims: Interval colorectal cancer (CRC) is largely related to a poor endoscopic performance or different biology in the development of the polyp. However, patient-related factors were less investigated for their association with interval cancer. We thus evaluated tumor and patient characteristics as predictors of interval cancer in a population from Israel. Methods: In this retrospective study, patients that were diagnosed with colon cancer in our institution and had 2 colonoscopies were included. Demographic parameters and tumor characteristics were compared between 84 cases with interval cancer, occurring 1–10 years after a negative colonoscopy, and 983 patients with primary CRC. In addition, patient-related features, including diabetes and diverticulosis, were compared between 51 patients with interval cancer after negative colonoscopy and 255 controls with no cancer and a previous negative colonoscopy. Results: Compared to “positive” controls with primary cancer, patients with interval cancer were older (age 71.3 vs. 67.6, p = 0.003), had proximal tumor location (57 vs. 34%, p < 0.001) and non-advanced (0–2) tumor staging (78.5 vs. 64.8%, p = 0.014). Compared with -“negative” healthy controls, cases with interval cancer had only higher prevalence of diabetes (31 vs. 15%, p = 0.002). No significant differences were seen between patients with interval cancer occurring < 3 years and after 3–10 years. Conclusions: Patients with Interval cancer tend to be older and have diabetes. These patient groups should be more carefully or more frequently screened for pre-malignant lesions.

Baxter NN, Warren JL, Barrett MJ, Stukel TA, Doria-Rose VP: Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopist specialty. J Clin Oncol 2012; 30: 2664–2669.
Doubeni CA, Weinmann S, Adams K, Kamineni A, Buist DS, Ash AS, et al: Screening colonoscopy and risk for incident late-stage colorectal cancer diagnosis in average-risk adults: a nested case-control study. Ann Intern Med 2013; 158(5 pt 1): 312–320.
Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J, et al: Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 2010; 362: 1795–1803.
Cooper GS, Xu F, Barnholtz Sloan JS, Schluchter MD, Koroukian SM: Prevalence and predictors of interval colorectal cancers in medicare beneficiaries. Cancer 2012; 118: 3044–3052.
Baxter NN, Sutradhar R, Forbes SS, Paszat LF, Saskin R, Rabeneck L: Analysis of administrative data finds endoscopist quality measures associated with postcolonoscopy colorectal cancer. Gastroenterology 2011; 140: 65–72.
Singh H, Nugent Z, Demers AA, Bernstein CN: Rate and predictors of early/missed colorectal cancers after colonoscopy in Manitoba: a population-based study. Am J Gastroenterol 2010; 105: 2588–2596.
Singh H, Nugent Z, Mahmud SM, Demers AA, Bernstein CN: Predictors of colorectal cancer after negative colonoscopy: a population-based study. Am J Gastroenterol 2010; 105: 663–673.
Brenner H, Chang-Claude J, Seiler CM, Hoffmeister M: Interval cancers after -negative colonoscopy: population-based case-control study. Gut 2012; 61: 1576–1582.
Erichsen R, Baron JA, Stoffel EM, Laurberg S, Sandler RS, Sorensen HT: Characteristics and survival of interval and sporadic colorectal cancer patients: a nationwide population-based cohort study. Am J Gastroenterol 2013; 108: 1332–1340.
Samadder NJ, Curtin K, Tuohy TM, Pappas L, Boucher K, Provenzale D, et al: Characteristics of missed or interval colorectal cancer and patient survival: a population-based study. Gastroenterology 2014; 146: 950–960.
Cooper GS, Xu F, Schluchter MD, Koroukian SM, Barnholtz Sloan JS: Diverticulosis and the risk of interval colorectal cancer. Dig Dis Sci 2014; 59: 2765–2772.
Singh S, Singh PP, Murad MH, Singh H, Samadder NJ: Prevalence, risk factors, and outcomes of interval colorectal cancers: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 1375–1389.
le Clercq CM, Bouwens MW, Rondagh EJ, Bakker CM, Keulen ET, de Ridder RJ, et al: Postcolonoscopy colorectal cancers are preventable: a population-based study. Gut 2014; 63: 957–963.
Yuhara H, Steinmaus C, Cohen SE, Corley DA, Tei Y, Buffler PA: Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer? Am J Gastroenterol 2011; 106: 1911–1922.
Bressler B, Paszat LF, Vinden C, Li C, He J, Rabeneck L: Colonoscopic miss rates for right-sided colon cancer: a population-based analysis. Gastroenterology 2004; 127: 452–456.
Farrar WD, Sawhney MS, Nelson DB, Lederle FA, Bond JH: Colorectal cancers found after a complete colonoscopy. Clin Gastroenterol Hepatol 2006; 4: 1259–1264.
Hosokawa O, Shirasaki S, Kaizaki Y, Hayashi H, Douden K, Hattori M: Invasive colorectal cancer detected up to 3 years after a colonoscopy negative for cancer. Endoscopy 2003; 35: 506–510.
Sawhney MS, Farrar WD, Gudiseva S, Nelson DB, Lederle FA, Rector TS, et al: Microsatellite instability in interval colon cancers. Gastroenterology 2006; 131: 1700–1705.
Arain MA, Sawhney M, Sheikh S, Anway R, Thyagarajan B, Bond JH, et al: CIMP status of interval colon cancers: another piece to the puzzle. Am J Gastroenterol 2010; 105: 1189–1195.
Shaukat A, Arain M, Anway R, Manaktala S, Pohlman L, Thyagarajan B: Is KRAS mutation associated with interval colorectal cancers? Dig Dis Sci 2012; 57: 913–917.
Robertson DJ, Lieberman DA, Winawer SJ, Ahnen DJ, Baron JA, Schatzkin A, et al: Colorectal cancers soon after colonoscopy: a pooled multicohort analysis. Gut 2014; 63: 949–956.
Phipps AI, Limburg PJ, Baron JA, Burnett-Hartman AN, Weisenberger DJ, Laird PW, et al: Association between molecular subtypes of colorectal cancer and patient survival. Gastroenterology 2015; 148: 77–87.
Aleksandrova K, Boeing H, Jenab M, Bas Bueno-de-Mesquita H, Jansen E, van Duijnhoven FJ, et al: Metabolic syndrome and risks of colon and rectal cancer: the European prospective investigation into cancer and nutrition study. Cancer Prev Res (Phila) 2011; 4: 1873–1883.
Sandhu MS, Dunger DB, Giovannucci EL: Insulin, insulin-like growth factor-I (IGF-I), IGF binding proteins, their biologic interactions, and colorectal cancer. J Natl Cancer Inst 2002; 94: 972–980.
Schoen RE, Weissfeld JL, Kuller LH, et al: Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps. Gastroenterology 2005; 129: 464–475.
Hou YC, Hu Q, Huang J, Fang JY, Xiong H: Metformin therapy and the risk of colorectal adenoma in patients with type 2 diabetes: a meta-analysis. Oncotarget 2017; 8: 8843–8853.
Serper M, Gawron AJ, Smith SG, Pandit AA, Dahlke AR, Bojarski EA, et al: Patient factors that affect quality of colonoscopy preparation. Clin Gastroenterol Hepatol 2014; 12: 451–457.
Bressler B, Paszat LF, Chen Z, Rothwell DM, Vinden C, Rabeneck L: Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology 2007; 132: 96–102.
Cooper GS, Xu F, Schluchter MD, Koroukian SM, Barnholtz Sloan JS: Diverticulosis and the risk of interval colorectal cancer. Dig Dis Sci 2014; 59: 2765–2772.
Lee SJ, Kim SA, Ku BH, Kim HY, Kim JY, Chang DK, et al: Association between colorectal cancer and colonic diverticulosis: case-control study based on computed tomographic colonography. Abdom Imaging 2012; 37: 70–73.
Granlund J, Svensson T, Granath F, Hjern F, Ekbom A, Blomqvist P, et al: Diverticular disease and the risk of colon cancer – a population-based case-control study. Aliment Pharmacol Ther 2011; 34: 675–681.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.