Miguel YS, Demb J, Martinez ME, et al. - Among individuals who had undergone diagnostic colonoscopy after an abnormal stool-based screening, the relationship between time to colonoscopy and colorectal cancer (CRC) outcomes was explored. Between 1999 and 2010, researchers conducted a retrospective cohort study of Veterans aged 50-75 years with an abnormal fecal occult blood test (FOBT) or fecal immunochemical test (FIT). Multivariable Cox proportional hazards were applied to generate CRC-specific incidence and mortality hazard ratios (HRs) and 95% confidence intervals (CI) for 3-month colonoscopy intervals, with 1-3 months as the reference group. They further tested how time to colonoscopy relates to late-stage CRC diagnosis. A total of 204,733 patients were included in this cohort. After abnormal FIT/FOBT, greater time to colonoscopy is correlated with greater risk of CRC incidence, death, and late-stage CRC. There was an increased CRC risk for patients who received a colonoscopy at 13-15 months, 16-18 months, 19-21 months, and 22-24 months vs patients who received a colonoscopy at 1-3 months. Mortality risk was greater in groups who received a colonoscopy at 19-21 months and 22-44 months vs patients who received a colonoscopy at 1-3 months. At 16 months, the likelihood of late stage CRC increased. Diagnostic follow-up within 1 year of an abnormal FIT/FOBT result should be emphasized in interventions to improve CRC outcomes.