Is surveillance colonoscopy necessary for all patients with bowel polyps?

Robbins, Emma C; Wooldrage, Kate; Cross, Amanda J.

doi:10.1136/bmj.m1706

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Surveillance colonoscopy accounts for approximately 20% of all colonoscopies performed in the United States and the United Kingdom [ 4 ], and determining the appropriate surveillance interval is important for endoscopists. Although clarity on the long-term risks of CRC after polypectomy and the population that may benefit from surveillance colonoscopy is lacking [ 5 ], appropriate surveillance may reduce such risks, especially in high-risk patients [ 4 , 6 ]. Therefore, referring to the guidelines regarding post-polypectomy surveillance intervals is recommended [ 7 - 9 ].…”

Section: Introductionmentioning

confidence: 99%

A survey of current practices in post-polypectomy surveillance in Korea

Kim,

Gweon,

Kwak

et al. 2024

Intest Res

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Background/Aims: We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists.Methods: In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed.Results: In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1–2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3–10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1–4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5–10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%–55.1%) discontinued the surveillance at the patient age of 80–84 years.Conclusions: A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.

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Section: Introductionmentioning

confidence: 99%

A survey of current practices in post-polypectomy surveillance in Korea

Kim,

Gweon,

Kwak

et al. 2024

Intest Res

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“… 12 , 13 However, there are limited data that colonoscopy surveillance reduces CRC incidence or mortality. 7 , 14 , 15 , 16 As a result, clinical guidelines for colonoscopy surveillance vary widely and lack sufficient support. 7 , 17 , 18 , 19 , 20 Furthermore, adherence to the surveillance recommendations has been shown to be poor, with the reported prevalence of less than 15%, and there is overuse of surveillance colonoscopy in low-risk patients and underuse in high-risk patients.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a risk prediction model for post-polypectomy colorectal cancer in the USA: a prospective cohort study

Knudsen,

Wang,

Wang

et al. 2023

eClinicalMedicine

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“…A number of studies have reported improvements in the quality of gastrointestinal endoscopy 3 – 6 . However, recent studies disputed the success and effect of surveillance colonoscopy in some patients such as intermediate-risk patients 7 – 9 and reported the inaccurate delineation of non-polypoid lesions 10 , 11 . Conventional white-light colonoscopy has high sensitivity; however, it tends to miss small, flat, or depressed lesions that are potentially invasive, resulting in progression to advanced tumors 12 – 14 .…”

Section: Introductionmentioning

confidence: 99%

Biomolecular imaging of colorectal tumor lesions using a FITC-labeled scFv-Cκ fragment antibody

Kim

et al. 2021

Sci Rep

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For the sensitive diagnosis of colorectal cancer lesions, advanced molecular imaging techniques using cancer-specific targets have emerged. However, issues regarding the clearance of unbound probes and immunogenicity remain unresolved. To overcome these limitations, we developed a small-sized scFv antibody fragment conjugated with FITC for the real-time detection of colorectal cancer by in vivo molecular endoscopy imaging. A small-sized scFv fragment can target colon cancer secreted protein-2 (CCSP-2), highly expressed in colorectal adenocarcinoma tissues; moreover, its full-length IgG probe has been used for molecular imaging previously. To assess the efficacy of anti-CCSP-2 scFv-FITC, surgical specimens were obtained from 21 patients with colorectal cancer for ex vivo molecular fluorescence analysis, histology, and immunohistochemistry. Orthotopic mice were administered with anti-CCSP-2 scFv-FITC topically and intravenously, and distinct tumor lesions were observed by real-time fluorescence colonoscopy. The fluorescence imaging of human colon cancer specimens allowed the differentiation of malignant tissues from non-malignant tissues (p < 0.05), and the CCSP-2 expression level was found to be correlated with the fluorescence intensity. Here, we demonstrated the feasibility and safety of anti-CCSP-2 scFv-FITC for molecular imaging as well as its potential in real-time fluorescence colonoscopy for the differential diagnosis of tumor lesions.

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Is surveillance colonoscopy necessary for all patients with bowel polyps?

Cited by 5 publications

References 19 publications

A survey of current practices in post-polypectomy surveillance in Korea

A survey of current practices in post-polypectomy surveillance in Korea

Development and validation of a risk prediction model for post-polypectomy colorectal cancer in the USA: a prospective cohort study

Biomolecular imaging of colorectal tumor lesions using a FITC-labeled scFv-Cκ fragment antibody

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