Abhinav Rao, MD1, Shivam Kalra, MBBS, MHA2, Brett D. Van Leer-Greenberg, MD3, Don Rockey, MD4 1Trident Medical Center, Charleston, SC; 2Trident Medical Center, North Charleston, SC; 3Palmetto Primary Care Physicians, Mt. Pleasant, SC; 4Medical University of South Carolina, Charleston, SC
Introduction: Multitarget stool DNA tests (i.e., Cologuard®) are currently used in average-risk patients as a primary method of screening for colorectal cancer (CRC). However, Cologuard® is also being used in patients who previously underwent colonoscopy who wish to avoid repeat colonoscopy. Here, in a large primary care practice setting, our aim was to evaluate the diagnostic performance of Cologuard® in patients who had a previously normal colonoscopy.
Methods: This retrospective cohort study included an analysis of 5,827 patients from 35 different primary locations in South Carolina. Patients aged 45 and above with a previously documented normal, high quality colonoscopy prior to Cologuard® test date were included. High-risk patients and those with a previous negative Cologuard® result were excluded.
Results: Of 5,827 ordered Cologuard® tests, 248 patients had prior colonoscopies. The average time from initial colonoscopy to Cologuard® testing was 7.3 years. Of the 63 patients who had a positive Cologuard® test, 41 patients (65%) completed follow-up colonoscopy. Among these, 40 patients had complete colonoscopy data. Of these 40 patients, 12 patients (30%) had advanced adenomas and 0 had colon cancer. Compared to patients without a previous colonoscopy, patients with prior colonoscopies had fewer adenomas of all types (1.62 vs 2.35) and fewer advanced adenomas (1.41 vs 1.95).
Discussion: Patients with a previously negative colonoscopy and subsequent positive Cologuard® were found to have a high rate of advanced adenomas on follow-up colonoscopy (30%). Thus, in patients with a previously negative colonoscopy, Cologuard® may be an effective follow-up screening tool.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Abhinav Rao indicated no relevant financial relationships.
Shivam Kalra indicated no relevant financial relationships.
Brett Van Leer-Greenberg: Sanofi S.A. – Advisory Committee/Board Member.
Don Rockey indicated no relevant financial relationships.
Abhinav Rao, MD1, Shivam Kalra, MBBS, MHA2, Brett D. Van Leer-Greenberg, MD3, Don Rockey, MD4. P3845 - The Utility of Cologuard for CRC Screening After a Normal Colonoscopy, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
