Second-Look Colonoscopies and the Impact on Capacity in FIT-Based XXXX .

@entity1 @entity1313 @entity5 @entity1442 @entity14 @entity652
OBJECTIVES: Fecal immunochemical testing (FIT) and colonoscopy are tandem procedures in @entity14 ( @entity14 ) screening. A positive FIT predicts @entity1442 ( @entity1442 ) that requires endoscopic detection and removal. En bloc or piecemeal resection of @entity1442 is associated with a significant rate of residual or recurrent @entity5 . Second-look colonoscopies are indicated to assess @entity1442 . These colonoscopies can make a substantial demand on colonoscopy capacity and health-care system. This study is the first to evaluate the demand and risk factors for second-look colonoscopy in FIT @entity14 screening. METHODS: All colonoscopies after a positive FIT, in subjects aged 50-74 years approached for 3 rounds of FIT screening, were prospectively registered. Second-look colonoscopies were defined as any colonoscopy within 1 year following a colonoscopy after positive FIT. RESULTS: Out of 1,215 FIT-positive screenees undergoing colonoscopy, 105 (8.6%) @entity1 underwent a second-look colonoscopy, of whom 30 (2.5%) underwent more than one colonoscopy (range 2-9), leading to a total of 149 (12.3%) additional colonoscopies. Main reasons for second-look colonoscopies were assessment of complete @entity1442 removal (41.9%) and need for additional polypectomy (34.3%). Risk factors were advanced @entity652 and poor bowel preparation (P<0.001). High fecal hemoglobin concentration was the only predictor of a second-look colonoscopy before index colonoscopy (P<0.001). CONCLUSIONS: Second-look colonoscopies have substantial impact on colonoscopy resources, increasing the demand with 12%. The main reasons for these second-look colonoscopies were previous incomplete polypectomy and control of @entity1313 . A high fecal hemoglobin concentration as measured by FIT can help to identify @entity1 at risk of a second-look colonoscopy.
