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- Title
Low detection rate of advanced neoplasia within 5 years after polypectomy of small serrated adenoma.
- Authors
Duochen Jin; Hailong Cao; Shah, Bikash Kumar; Danfeng Chen; Yujie Zhang; Tianyu Liu; Wenxiao Dong; Sinan Wang; Yanrong Qi; Bangmao Wang; Jin, Duochen; Cao, Hailong; Chen, Danfeng; Zhang, Yujie; Liu, Tianyu; Dong, Wenxiao; Wang, Sinan; Qi, Yanrong; Wang, Bangmao
- Abstract
<bold>Aim: </bold>Patients with small serrated adenomas (SAs) (<10 mm) often undergo surveillance colonoscopy before the routine recommended time. We aimed to determine the appropriate surveillance intervals following polypectomy of small SAs for symptomatic patients.<bold>Method: </bold>We retrospectively reviewed the data of 638 patients, including 122 cases and 516 controls. Subjects in the case group had small SAs at baseline colonoscopy, including sessile SA/polyps and traditional SAs, while subjects in the control group had negative findings. All patients underwent at least one surveillance colonoscopy during the following 5 years.<bold>Results: </bold>There was no significant difference in the incidence rate of advanced neoplasia between the two groups over a 5-year duration (3.6% vs 2.6%, p=0.455). Moreover, both groups also showed a low prevalence of SA formation over 1-5 years (3.6% vs 1.0%, p=0.145). Patients with baseline SA tended to undergo the first surveillance colonoscopy earlier than those without adenoma (≤1 year vs 1 to ≤3 years). Seventy-one (11.1%) of the total included subjects underwent inadequate initial colonoscopy, and 30 (42.3%) underwent early surveillance of adenoma formation within 1 year. Patients with a family history of colorectal cancer (OR 4.69, 95% CI 1.48 to 14.71, p=0.017) or inadequate baseline colonoscopy (OR 3.17, 95% CI 1.202 to 8.409, p=0.035) were at a higher risk of metachronous adenoma formation during the surveillance period.<bold>Conclusion: </bold>Patients with small SAs at baseline gain little benefit from follow-up of colonoscopy within 5 years after complete polypectomy.
- Subjects
COLON polyps; ADENOMATOUS polyps; HEALTH service areas
- Publication
Postgraduate Medical Journal, 2019, Vol 95, Issue 1122, p187
- ISSN
0032-5473
- Publication type
journal article
- DOI
10.1136/postgradmedj-2018-136285