BACKGROUND & AIMS: All patients with colorectal adenomas may not require identical follow-up. We aimed to determine if adenoma characteristics at initial colonoscopy could predict adenoma recurrence or characteristics at follow-up. METHODS: The number of adenomas and the size, type, and degree of atypia in 479 patients in a polyp prevention trial were evaluated as predictors of the same characteristics at follow-up using odds ratios (ORs) with 95% confidence intervals (CIs). Multiple logistic regression analysis was performed to determine if several baseline characteristics were simultaneously associated with outcome. RESULTS: Although several characteristics were significant predictors of recurrence univariately, by multivariate analysis, multiple adenomas at follow-up were more likely when patients had > or = 3 baseline adenomas (OR, 2.25; 95% CI, 1.20-4.21) or at least 1 tubulovillous adenoma (OR, 2.12; 95% CI, 1.12-4.02). No specific characteristic was associated with recurrence of high-risk polyps (> or = 1 cm, villous, severe atypia). Seventy percent of patients with 1 or 2 baseline adenomas had no recurrence, and only 3.3% had any adenomas of clinical concern. CONCLUSIONS: Number and type of baseline adenomas predict recurrent adenomas, but the recurrence is rarely of clinical concern. Patients with 1 or 2 tubular adenomas constitute a low-risk group for whom follow-up might be extended beyond 3 years.
BACKGROUND & AIMS: All patients with colorectal adenomas may not require identical follow-up. We aimed to determine if adenoma characteristics at initial colonoscopy could predict adenoma recurrence or characteristics at follow-up. METHODS: The number of adenomas and the size, type, and degree of atypia in 479 patients in a polyp prevention trial were evaluated as predictors of the same characteristics at follow-up using odds ratios (ORs) with 95% confidence intervals (CIs). Multiple logistic regression analysis was performed to determine if several baseline characteristics were simultaneously associated with outcome. RESULTS: Although several characteristics were significant predictors of recurrence univariately, by multivariate analysis, multiple adenomas at follow-up were more likely when patients had > or = 3 baseline adenomas (OR, 2.25; 95% CI, 1.20-4.21) or at least 1 tubulovillous adenoma (OR, 2.12; 95% CI, 1.12-4.02). No specific characteristic was associated with recurrence of high-risk polyps (> or = 1 cm, villous, severe atypia). Seventy percent of patients with 1 or 2 baseline adenomas had no recurrence, and only 3.3% had any adenomas of clinical concern. CONCLUSIONS: Number and type of baseline adenomas predict recurrent adenomas, but the recurrence is rarely of clinical concern. Patients with 1 or 2 tubular adenomas constitute a low-risk group for whom follow-up might be extended beyond 3 years.
Authors: María Elena Martínez; John A Baron; David A Lieberman; Arthur Schatzkin; Elaine Lanza; Sidney J Winawer; Ann G Zauber; Ruiyun Jiang; Dennis J Ahnen; John H Bond; Timothy R Church; Douglas J Robertson; Stephanie A Smith-Warner; Elizabeth T Jacobs; David S Alberts; E Robert Greenberg Journal: Gastroenterology Date: 2008-12-09 Impact factor: 22.682
Authors: Rafiq A Sheikh; Byung Hee Min; Shagufta Yasmeen; Raymond Teplitz; Henry Tesluk; Boris Henry Ruebner; Martin Tobi; James Hatfield; Suzanne Fligiel; Michael J Lawson Journal: Dig Dis Sci Date: 2003-01 Impact factor: 3.199
Authors: Douglas J Robertson; Carol A Burke; H Gilbert Welch; Robert W Haile; Robert S Sandler; E Robert Greenberg; Dennis J Ahnen; Robert S Bresalier; Richard I Rothstein; Bernard Cole; Leila A Mott; John A Baron Journal: Ann Intern Med Date: 2009-07-21 Impact factor: 25.391