Objective To review and summarise the evidence on the prevalence of colorectal adenomas and cancers at a follow-up screening colonoscopy after negative index colonoscopy, stratified by interval between examinations and by sex.
Design Systematic review and meta-analysis of all available studies.
Data sources PubMed, Web of Science, and Embase. Two investigators independently extracted characteristics and results of identified studies and performed standardised quality ratings.
Eligibility criteria Studies assessing the outcome of a follow-up colonoscopy among participants at average risk for colorectal cancer with a negative previous colonoscopy (no adenomas).
Results 28 studies were identified, including 22 cohort studies, five cross sectional studies, and one case-control study. Findings for an interval between colonoscopies of one to five, five to 10, and more than 10 years were reported by 17, 16, and three studies, respectively. Summary estimates of prevalences of any neoplasm were 20.7% (95% confidence interval 15.8% to 25.5%), 23.0% (18.0% to 28.0%), and 21.9% (14.9% to 29.0%) for one to five, five to 10, and more than 10 years between colonoscopies. Corresponding summary estimates of prevalences of any advanced neoplasm were 2.8% (2.0% to 3.7%), 3.2% (2.2% to 4.1%), and 7.0% (5.3% to 8.7%). Seven studies also reported findings stratified by sex. Summary estimates stratified by interval and sex were consistently higher for men than for women.
Conclusions Although detection of any neoplasms was observed in more than 20% of participants within five years of a negative screening colonoscopy, detection of advanced neoplasms within 10 years was rare. Our findings suggest that 10 year intervals for colonoscopy screening after a negative colonoscopy, as currently recommended, may be adequate, but more studies are needed to strengthen the empirical basis for pertinent recommendations and to investigate even longer intervals.
Study registration Prospero CRD42019127842.

中文翻译：

---

一般风险人群结肠镜检查阴性的随访结果：系统评价和荟萃分析

目的回顾和总结阴性指数结肠镜检查后的随访筛查结肠镜检查中结直肠腺瘤和癌症患病率的证据，按检查间隔和性别分层。
设计对所有可用研究进行系统回顾和荟萃分析。
数据来源PubMed、Web of Science 和 Embase。两名研究人员独立提取已确定研究的特征和结果，并进行标准化质量评级。
资格标准研究评估结肠镜检查结果为平均结直肠癌风险且既往结肠镜检查结果为阴性（无腺瘤）的参与者的后续结肠镜检查结果。
结果共确定了 28 项研究，其中包括 22 项队列研究、5 项横断面研究和 1 项病例对照研究。17 项、16 项和 3 项研究分别报告了结肠镜检查间隔 1 至 5 年、5 至 10 年和 10 年以上的结果。对于 1 至 5 例、5 至 10 例，任何肿瘤患病率的汇总估计分别为 20.7%（95% 置信区间为 15.8% 至 25.5%）、23.0%（18.0% 至 28.0%）和 21.9%（14.9% 至 29.0%）。 ，并且结肠镜检查间隔超过 10 年。任何晚期肿瘤患病率的相应汇总估计为2.8%（2.0%至3.7%）、3.2%（2.2%至4.1%）和7.0%（5.3%至8.7%）。七项研究还报告了按性别分层的研究结果。按时间间隔和性别分层的汇总估计值，男性始终高于女性。
结论尽管在结肠镜检查阴性筛查后的 5 年内，超过 20% 的参与者检测到任何肿瘤，但 10 年内检测到晚期肿瘤的情况很少见。我们的研究结果表明，按照目前的建议，结肠镜检查阴性后间隔 10 年进行结肠镜检查可能就足够了，但需要更多的研究来加强相关建议的经验基础，并调查更长的间隔。
研究注册Prospero CRD42019127842。