Low detection rate of advanced neoplasia within 5 years after polypectomy of small serrated adenoma

Abstract

AimPatients 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.MethodWe 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.ResultsThere 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.ConclusionPatients with small SAs at baseline gain little benefit from follow-up of colonoscopy within 5 years after complete polypectomy.

Outcomes at follow-up of negative colonoscopy in average risk population: systematic review and meta-analysis

“…Fifteen studies were from the Western hemisphere,3 8 20 21 23 25 29 30 32 33 35 36 37 38 39 and 13 were from the Eastern hemisphere 2224 26 27 28 31 34 40 41 42 44 45 Twenty two studies were cohort studies,3 8 20 22 24 25 27 28 29 30 31 32 34 37 38 39 40 41 42 43 44 45 and five were cross sectional studies 2123 26 35 36 One study was a case-control study in which the control group was prospectively followed up 33…”

Reevaluation of a rightward shift in colorectal cancer: A single‐center retrospective study in Tianjin

“…Colonoscopy screening has been widely recognized to reduce both prevalence and mortality of CRC, and the prevalence of the disease decreases after 5 years of screening . Our previous work revealed a low detection rate of advanced neoplasia within 5 years after polypectomy . The Tianjin community‐based CRC screening program was initiated in 2012, and the detection rate of CRC significantly decreased from 2.67% in 2012 to 2.15% in 2017 ( P < .001), which is probably due to the progress made in screening.…”

“…33 Our previous work revealed a low detection rate of advanced neoplasia within 5 years after polypectomy. 34,35 The Tianjin community-based CRC screening program was initiated in 2012, 36 and the detection rate of CRC significantly decreased from 2.67% in 2012 to 2.15% in 2017 (P < .001), which is probably due to the progress made in screening.…”