Abstract
Background
Data regarding outcomes for patients with multiple findings for high-risk adenomas are scarce.
Aim
To compare the risk for colorectal neoplasm (CRN) recurrence according to the number of high-risk findings.
Methods
This was a retrospective and multicenter study. Patients who had one or more high-risk adenomas at the index colonoscopy and underwent follow-up colonoscopy 2.5 or more years after the index colonoscopy were included. The number of high-risk findings was defined as follows: number of adenomas larger than 1 cm + number of adenomas with HGD + number of adenomas with a villous component + existence (counted as 1) or nonexistence (counted as 0) of three or more adenomas.
Results
A total of 1646 patients were included, and the mean duration between index and follow-up colonoscopy was approximately 4 years. The cumulative incidence rate of recurrent advanced CRN in patients with three or more high-risk findings was higher than that in patients with one or two high-risk findings (p < 0.001). However, the difference in 3-year cumulative incidence rates of recurrent advanced CRN between the two groups was not great, although it was statistically significant (4.8 vs. 2.3 %, p = 0.039).
Conclusions
A 3-year surveillance interval for patients with multiple high-risk findings, regardless of the number of high-risk findings, appears reasonable.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kim ER, Kim YH. Clinical application of genetics in management of colorectal cancer. Intest Res. 2014;12:184–193.
Cha JM. Colonoscopy quality is the answer for the emerging issue of interval cancer. Intest Res. 2014;12:110–116.
Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977–1981.
Baxter NN, Goldwasser MA, Paszat LF, et al. Association of colonoscopy and death from colorectal cancer. Ann Intern Med. 2009;150:1–8.
Lin OS, Kozarek RA, Cha JM. Impact of sigmoidoscopy and colonoscopy on colorectal cancer incidence and mortality: an evidence-based review of published prospective and retrospective studies. Intest Res. 2014;12:268–274.
Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–857.
Martinez ME, Sampliner R, Marshall JR, et al. Adenoma characteristics as risk factors for recurrence of advanced adenomas. Gastroenterology. 2001;120:1077–1083.
Lieberman DA, Weiss DG, Harford WV, et al. Five-year colon surveillance after screening colonoscopy. Gastroenterology. 2007;133:1077–1085.
Martinez ME, Baron JA, Lieberman DA, et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology. 2009;136:832–841.
Martinez ME, Thompson P, Messer K, et al. One-year risk for advanced colorectal neoplasia: U.S. versus U.K. risk-stratification guidelines. Ann Intern Med. 2012;157:856–864.
Wen CP, David Cheng TY, Tsai SP, et al. Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutr. 2009;12:497–506.
Bonithon-Kopp C, Piard F, Fenger C, et al. Colorectal adenoma characteristics as predictors of recurrence. Dis Colon Rectum. 2004;47:323–333.
Winawer SJ, Zauber AG, O’Brien MJ, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med. 1993;328:901–906.
Chung SJ, Kim YS, Yang SY, et al. Five-year risk for advanced colorectal neoplasia after initial colonoscopy according to the baseline risk stratification: a prospective study in 2452 asymptomatic Koreans. Gut. 2011;60:1537–1543.
Atkin WS, Morson BC, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med. 1992;326:658–662.
Noshirwani KC, van Stolk RU, Rybicki LA, et al. Adenoma size and number are predictive of adenoma recurrence: implications for surveillance colonoscopy. Gastrointest Endosc. 2000;51:433–437.
Seo JY, Chun J, Lee C, et al. Novel risk stratification for recurrence after endoscopic resection of advanced colorectal adenoma. Gastrointest Endosc. 2015;81:655–664.
Nusko G, Mansmann U, Kirchner T, et al. Risk related surveillance following colorectal polypectomy. Gut. 2002;51:424–428.
Woodward TA, Heckman MG, Cleveland P, et al. Predictors of complete endoscopic mucosal resection of flat and depressed gastrointestinal neoplasia of the colon. Am J Gastroenterol. 2012;107:650–654.
Mannath J, Subramanian V, Singh R, et al. Polyp recurrence after endoscopic mucosal resection of sessile and flat colonic adenomas. Dig Dis Sci. 2011;56:2389–2395.
Compliance with ethical standards
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding authors
Rights and permissions
About this article
Cite this article
Jung, Y.S., Park, D.I., Kim, W.H. et al. Risk of Advanced Colorectal Neoplasia According to the Number of High-Risk Findings at Index Colonoscopy: A Korean Association for the Study of Intestinal Disease (KASID) Study. Dig Dis Sci 61, 1661–1668 (2016). https://doi.org/10.1007/s10620-016-4038-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10620-016-4038-0