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Probability of High-Risk Colorectal Neoplasm Recurrence Based on the Results of Two Previous Colonoscopies

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Abstract

Background

Current guidelines for the surveillance colonoscopy interval are largely based on the most recent colonoscopy findings.

Aim

We aimed to evaluate differences in the probability of high-risk neoplasm recurrence according to the two previous colonoscopy findings.

Methods

This was a retrospective cohort study from a tertiary-care center. A total of 4,143 subjects who underwent three or more colonoscopies for screening or surveillance purposes from January 2001 to December 2011 were enrolled. We compared the probability of high-risk neoplasm detection on follow-up colonoscopies after the second colonoscopy based on risk categories in both the second and first colonoscopies.

Results

At the final colonoscopy, 370 participants (8.9 %) had high-risk neoplasms. In patients with a normal second colonoscopy, the probability of high-risk neoplasm recurrence was different between those with normal, low-risk, and high-risk findings at the first colonoscopy (3.8, 6.8, and 17.7 %, respectively). The hazard ratio of a high-risk neoplasm at the final colonoscopy for patients with a normal second and low-risk first colonoscopy over a normal second and normal first colonoscopy was 3.07 (95 % CI 2.04–4.64, P < 0.001). The hazard ratio of high-risk neoplasm at the final colonoscopy for patients with a normal second and high-risk first colonoscopy over a normal second with normal first colonoscopy was 7.88 (95 % CI 4.90–12.67, P < 0.001).

Conclusions

The rate of high-risk colorectal neoplasm recurrence differs according to the two previous colonoscopy findings. Therefore, surveillance intervals could be adjusted not just only by the most recent colonoscopy findings but also by considering two previous colonoscopy findings.

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Conflict of interest

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Authors and Affiliations

  1. Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Hye Won Park, Ji Young Lee, Hye-Sook Chang & Jaewon Choe

  2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seungbong Han

  3. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Korea

    Yunsik Choi, Hoonsub So, Dong-Hoon Yang, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim & Jeong-Sik Byeon

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  1. Hye Won Park
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  2. Seungbong Han
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  3. Ji Young Lee
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  4. Hye-Sook Chang
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Corresponding author

Correspondence to Jeong-Sik Byeon.

Additional information

Hye Won Park and Seungbong Han have contributed equally to this study.

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Park, H.W., Han, S., Lee, J.Y. et al. Probability of High-Risk Colorectal Neoplasm Recurrence Based on the Results of Two Previous Colonoscopies. Dig Dis Sci 60, 226–233 (2015). https://doi.org/10.1007/s10620-014-3334-9

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  • DOI: https://doi.org/10.1007/s10620-014-3334-9

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