OBJECTIVE: Surveillance of patients treated for adenoma or colorectal cancer (CRC) is intended to reduce the incidence of CRC. Responsibility for the adherence to surveillance advice is often left to the patients and family physician. It is not known whether this type of passive policy affects the efficacy of surveillance. The aim of this study was to determine the yield of surveillance without active invitation to follow-up endoscopy. MATERIAL AND METHODS: The study comprised a cohort follow-up of patients under 75 years of age with adenomas or CRC at index endoscopy in the period 1997-99. Adherence and intervals of follow-up endoscopy were determined up to December 2004. RESULTS: During the inclusion period 2946 patients underwent lower endoscopy. In total, 393 patients were newly diagnosed with colorectal polyps (n=280) or CRC (n=113). Polyps were classified as adenomas in 167/280 (61%) patients. Forty-five (27%) of the adenoma patients underwent surveillance endoscopy within the guideline interval, 63 (38%) underwent delayed endoscopy, and 59 (35%) did not have any follow-up at all. CRC was diagnosed in 113 patients. Thirty-six patients who died during the first year or were diagnosed with metastases were excluded from the analysis. Twenty-three (30%) of the remaining 77 patients underwent endoscopic surveillance according to the guidelines, 40 (52%) had delayed surveillance endoscopy, and 14/77 (18%) did not undergo surveillance endoscopy at all. CONCLUSIONS: In surveillance for colorectal neoplasia, active follow-up invitation is important. Given the low follow-up rate in our series, passive follow-up policies may lead to under-performance of surveillance programs. An active and controlled follow-up is advisable.
OBJECTIVE: Surveillance of patients treated for adenoma or colorectal cancer (CRC) is intended to reduce the incidence of CRC. Responsibility for the adherence to surveillance advice is often left to the patients and family physician. It is not known whether this type of passive policy affects the efficacy of surveillance. The aim of this study was to determine the yield of surveillance without active invitation to follow-up endoscopy. MATERIAL AND METHODS: The study comprised a cohort follow-up of patients under 75 years of age with adenomas or CRC at index endoscopy in the period 1997-99. Adherence and intervals of follow-up endoscopy were determined up to December 2004. RESULTS: During the inclusion period 2946 patients underwent lower endoscopy. In total, 393 patients were newly diagnosed with colorectal polyps (n=280) or CRC (n=113). Polyps were classified as adenomas in 167/280 (61%) patients. Forty-five (27%) of the adenomapatients underwent surveillance endoscopy within the guideline interval, 63 (38%) underwent delayed endoscopy, and 59 (35%) did not have any follow-up at all. CRC was diagnosed in 113 patients. Thirty-six patients who died during the first year or were diagnosed with metastases were excluded from the analysis. Twenty-three (30%) of the remaining 77 patients underwent endoscopic surveillance according to the guidelines, 40 (52%) had delayed surveillance endoscopy, and 14/77 (18%) did not undergo surveillance endoscopy at all. CONCLUSIONS: In surveillance for colorectal neoplasia, active follow-up invitation is important. Given the low follow-up rate in our series, passive follow-up policies may lead to under-performance of surveillance programs. An active and controlled follow-up is advisable.
Authors: Harmke van Kooten; Vincent de Jonge; Eline Schreuders; Jerome Sint Nicolaas; Monique E van Leerdam; Ernst J Kuipers; Sander J O Veldhuyzen van Zanten Journal: Can J Gastroenterol Date: 2012-02 Impact factor: 3.522
Authors: Eline Schreuders; Jerome Sint Nicolaas; Vincent de Jonge; Harmke van Kooten; Isaac Soo; Daniel Sadowski; Clarence Wong; Monique E van Leerdam; Ernst J Kuipers; Sander J O Veldhuyzen van Zanten Journal: Can J Gastroenterol Date: 2013-01 Impact factor: 3.522
Authors: Enikő Orosz; István Ember; Katalin Gombos; László Tóth; Ádám Tarpay; Ákos Pap; Szabolcs Ottó Journal: Pathol Oncol Res Date: 2013-07-19 Impact factor: 3.201
Authors: Joan C Smith; Michael W Schäffer; Billy R Ballard; Duane T Smoot; Alan J Herline; Samuel E Adunyah; Amosy E M'Koma Journal: J Cancer Ther Date: 2013
Authors: Else-Mariëtte B van Heijningen; Iris Lansdorp-Vogelaar; Ewout W Steyerberg; S Lucas Goede; Evelien Dekker; Wilco Lesterhuis; Frank ter Borg; Juda Vecht; Pieter Spoelstra; Leopold Engels; Clemens J M Bolwerk; Robin Timmer; Jan H Kleibeuker; Jan J Koornstra; Harry J de Koning; Ernst J Kuipers; Marjolein van Ballegooijen Journal: Gut Date: 2015-01-13 Impact factor: 23.059