Chung Hyun Tae1, Chang Mo Moon2, Seong-Eun Kim3, Sung-Ae Jung3, Chang Soo Eun4, Jae Jun Park5, Geom Seog Seo6, Jae Myung Cha7, Sung Chul Park8, Jaeyoung Chun9, Hyun Jung Lee10, Yunho Jung11, Jin Oh Kim12, Young-Eun Joo13, Dong Il Park14. 1. Department of Health Promotion Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea. 2. Department of Internal Medicine, School of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea. mooncm27@ewha.ac.kr. 3. Department of Internal Medicine, School of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea. 4. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea. 5. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 6. Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan, Republic of Korea. 7. Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 8. Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea. 9. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. 10. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 11. Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea. 12. Department of Internal Medicine, Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea. 13. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea. 14. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: An optimal surveillance program is important to prevent advanced colorectal neoplasm. In this context, we have evaluated the cumulative risk of high-risk adenoma (HRA) or colorectal cancer (CRC) according to surveillance interval time after polypectomy. In addition, we assessed risk factors for late surveillance to determine whether late surveillance can impact the risk of subsequent advanced colorectal neoplasm. METHODS: This was a multicenter retrospective cohort study involving 3562 subjects who had undergone removal of at least one adenoma at the index colonoscopy and who subsequently underwent a surveillance colonoscopy. The subjects were classified into an early, appropriate or late group depending on the timing of the surveillance colonoscopy, performed using modified U.S. RESULTS: With 3% of the study population with LRA and HRA at the index colonoscopy going on to develop HRA or CRC, the estimated surveillance intervals calculated would be 6.3 [95% confidence interval (CI) 5.42-7.10] years and 3.1 (95% CI 2.61-4.45) years, respectively. The predictors of late surveillance were female gender [odd ratio (OR) 1.21; 95% CI 1.04-1.40], having undergone the procedure in small-to-medium-sized cities (OR 1.92; 95% CI 1.36-2.72) and HRA at index colonoscopy (OR 1.37; 95% CI 1.19-1.59). The risk factors for subsequent HRA or CRC were late surveillance (OR 1.34; 95% CI 1.03-1.74), male gender (OR 2.13; 95% CI 1.54-2.95), having undergone the procedure in small-to-medium-sized cities (OR 1.63; 95% CI 1.11-2.40) and HRA at index colonoscopy (OR 2.60; 95% CI 2.04-3.33). CONCLUSIONS: Women, having undergone the procedure in small-to-medium-sized cities and the presence of an HRA at the index colonoscopy were found to be independent risk factors for late surveillance colonoscopy. Late surveillance is significantly predictive of subsequent HRA or CRC.
BACKGROUND: An optimal surveillance program is important to prevent advanced colorectal neoplasm. In this context, we have evaluated the cumulative risk of high-risk adenoma (HRA) or colorectal cancer (CRC) according to surveillance interval time after polypectomy. In addition, we assessed risk factors for late surveillance to determine whether late surveillance can impact the risk of subsequent advanced colorectal neoplasm. METHODS: This was a multicenter retrospective cohort study involving 3562 subjects who had undergone removal of at least one adenoma at the index colonoscopy and who subsequently underwent a surveillance colonoscopy. The subjects were classified into an early, appropriate or late group depending on the timing of the surveillance colonoscopy, performed using modified U.S. RESULTS: With 3% of the study population with LRA and HRA at the index colonoscopy going on to develop HRA or CRC, the estimated surveillance intervals calculated would be 6.3 [95% confidence interval (CI) 5.42-7.10] years and 3.1 (95% CI 2.61-4.45) years, respectively. The predictors of late surveillance were female gender [odd ratio (OR) 1.21; 95% CI 1.04-1.40], having undergone the procedure in small-to-medium-sized cities (OR 1.92; 95% CI 1.36-2.72) and HRA at index colonoscopy (OR 1.37; 95% CI 1.19-1.59). The risk factors for subsequent HRA or CRC were late surveillance (OR 1.34; 95% CI 1.03-1.74), male gender (OR 2.13; 95% CI 1.54-2.95), having undergone the procedure in small-to-medium-sized cities (OR 1.63; 95% CI 1.11-2.40) and HRA at index colonoscopy (OR 2.60; 95% CI 2.04-3.33). CONCLUSIONS:Women, having undergone the procedure in small-to-medium-sized cities and the presence of an HRA at the index colonoscopy were found to be independent risk factors for late surveillance colonoscopy. Late surveillance is significantly predictive of subsequent HRA or CRC.
Entities:
Keywords:
Adherence; Colonoscopy; Colorectal cancer
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