Risk of metachronous neoplastic lesions during post-polypectomy surveillance in individuals with advanced colorectal neoplasia at initial screening colonoscopy.
advanced colorectal neoplasia
colonoscopy
colorectal cancer screening
polypectomy
surveillance
Journal
Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
12
02
2021
received:
14
01
2021
accepted:
15
02
2021
pubmed:
25
2
2021
medline:
10
2
2022
entrez:
24
2
2021
Statut:
ppublish
Résumé
The evidence of associations between some types of advanced colorectal neoplasia (ACN) at baseline and the risk of metachronous neoplasia is inconsistent. This study aimed to elucidate the incidence of metachronous neoplasia during post-polypectomy surveillance in individuals with ACN at baseline and examine the risk factors for its high incidence. Data from individuals who underwent endoscopic resection for ACN and received surveillance colonoscopy were analyzed. Data from individuals with no neoplastic lesions at baseline were used as reference. The incidence of metachronous ACN and clinically significant neoplasia (ACN and nonadvanced adenomas sized ≥ 5 mm) were evaluated. Risk factors for the higher incidence of these lesions were examined in individuals with ACN at baseline. During the median follow-up period of 61.8 months, metachronous ACN and nonadvanced adenomas sized ≥ 5 mm were detected in 9.6% and 32.4% of individuals with ACN at baseline (n = 136), respectively. The cumulative incidence of metachronous ACN and clinically significant neoplasia in individuals with ACN at baseline (3-year incidence: 5.5% and 16.9%, respectively) was higher than that in individuals with no neoplastic lesions at baseline (P < 0.01 for both). The presence of advanced histology at baseline, ≥ 5 neoplastic lesions at baseline, and family history of colorectal cancer were identified as risk factors for the higher incidence of clinically significant neoplasia. The relatively high incidence of metachronous neoplasia in individuals with ACN at baseline was confirmed; careful surveillance is required for these individuals, particularly in those with the risk factors.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
The evidence of associations between some types of advanced colorectal neoplasia (ACN) at baseline and the risk of metachronous neoplasia is inconsistent. This study aimed to elucidate the incidence of metachronous neoplasia during post-polypectomy surveillance in individuals with ACN at baseline and examine the risk factors for its high incidence.
METHODS
METHODS
Data from individuals who underwent endoscopic resection for ACN and received surveillance colonoscopy were analyzed. Data from individuals with no neoplastic lesions at baseline were used as reference. The incidence of metachronous ACN and clinically significant neoplasia (ACN and nonadvanced adenomas sized ≥ 5 mm) were evaluated. Risk factors for the higher incidence of these lesions were examined in individuals with ACN at baseline.
RESULTS
RESULTS
During the median follow-up period of 61.8 months, metachronous ACN and nonadvanced adenomas sized ≥ 5 mm were detected in 9.6% and 32.4% of individuals with ACN at baseline (n = 136), respectively. The cumulative incidence of metachronous ACN and clinically significant neoplasia in individuals with ACN at baseline (3-year incidence: 5.5% and 16.9%, respectively) was higher than that in individuals with no neoplastic lesions at baseline (P < 0.01 for both). The presence of advanced histology at baseline, ≥ 5 neoplastic lesions at baseline, and family history of colorectal cancer were identified as risk factors for the higher incidence of clinically significant neoplasia.
CONCLUSIONS
CONCLUSIONS
The relatively high incidence of metachronous neoplasia in individuals with ACN at baseline was confirmed; careful surveillance is required for these individuals, particularly in those with the risk factors.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2230-2238Subventions
Organisme : National Cancer Center Research and Development Fund
ID : 30-A-16
Organisme : National Cancer Center Research and Development Fund
ID : 31-A-25
Informations de copyright
© 2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
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