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Article: Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer

TitleColonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
Authors
KeywordsAdvanced adenoma
Colon cancer
High risk polyps
Post-polypectomy colorectal cancer
Rectal Cancer
Sessile serrated adenoma
Issue Date2018
Citation
World Journal of Gastroenterology, 2018, v. 24, n. 8, p. 905-916 How to Cite?
AbstractAIM to determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS 84/4610 (1.8%) patients developed CRC at the polypectomy site within a median of 4.2 years (mean 4.89 years), and 1.2% (54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years (mean 6.67 years). Approximately, 30% (25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8% (15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC development at the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION Recognition that CRC may develop following AA/ TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality..
Persistent Identifierhttp://hdl.handle.net/10722/324498
ISSN
2023 Impact Factor: 4.3
2023 SCImago Journal Rankings: 1.063
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMouchli, Mohamad A.-
dc.contributor.authorOuk, Lidia-
dc.contributor.authorScheitel, Marianne R.-
dc.contributor.authorChaudhry, Alisha P.-
dc.contributor.authorFelmlee-Devine, Donna-
dc.contributor.authorGrill, Diane E.-
dc.contributor.authorRashtak, Shahrooz-
dc.contributor.authorWang, Panwen-
dc.contributor.authorWang, Junwen-
dc.contributor.authorChaudhry, Rajeev-
dc.contributor.authorSmyrk, Thomas C.-
dc.contributor.authorOberg, Ann L.-
dc.contributor.authorDruliner, Brooke R.-
dc.contributor.authorBoardman, Lisa A.-
dc.date.accessioned2023-02-03T07:03:29Z-
dc.date.available2023-02-03T07:03:29Z-
dc.date.issued2018-
dc.identifier.citationWorld Journal of Gastroenterology, 2018, v. 24, n. 8, p. 905-916-
dc.identifier.issn1007-9327-
dc.identifier.urihttp://hdl.handle.net/10722/324498-
dc.description.abstractAIM to determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS 84/4610 (1.8%) patients developed CRC at the polypectomy site within a median of 4.2 years (mean 4.89 years), and 1.2% (54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years (mean 6.67 years). Approximately, 30% (25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8% (15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC development at the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION Recognition that CRC may develop following AA/ TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality..-
dc.languageeng-
dc.relation.ispartofWorld Journal of Gastroenterology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAdvanced adenoma-
dc.subjectColon cancer-
dc.subjectHigh risk polyps-
dc.subjectPost-polypectomy colorectal cancer-
dc.subjectRectal Cancer-
dc.subjectSessile serrated adenoma-
dc.titleColonoscopy surveillance for high risk polyps does not always prevent colorectal cancer-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.3748/wjg.v24.i8.905-
dc.identifier.pmid29491684-
dc.identifier.pmcidPMC5829154-
dc.identifier.scopuseid_2-s2.0-85042678264-
dc.identifier.volume24-
dc.identifier.issue8-
dc.identifier.spage905-
dc.identifier.epage916-
dc.identifier.eissn2219-2840-
dc.identifier.isiWOS:000426310600004-

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