Five-year risk for advanced colorectal neoplasia after initial colonoscopy according to the baseline risk stratification: a prospective study in 2452 asymptomatic Koreans
ObjectivePostpolypectomy surveillance guidelines for colorectal cancer introduced the concept of ‘risk stratification’; however, few studies have been conducted for validation of its usefulness. The aim of this study was to assess the 5-year incidence of advanced neoplasia recurrence based on the ri...
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| Veröffentlicht in: | Gut 2011-11, Vol.60 (11), p.1537-1543 |
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| creator | Chung, Su Jin Kim, Young Sun Yang, Sun Young Song, Ji Hyun Kim, Donghee Park, Min Jung Kim, Sang Gyun Song, In Sung Kim, Joo Sung |
| description | ObjectivePostpolypectomy surveillance guidelines for colorectal cancer introduced the concept of ‘risk stratification’; however, few studies have been conducted for validation of its usefulness. The aim of this study was to assess the 5-year incidence of advanced neoplasia recurrence based on the risk stratification scheme of the guidelines and to identify its risk factors.MethodsA prospective study of surveillance colonoscopy after screening colonoscopy was carried out at the Seoul National University Hospital Healthcare System Gangnam Center. 3803 asymptomatic Koreans aged 50–69 were enrolled prospectively and 5-year cumulative adenoma rates were analysed according to three risk groups: normal (no baseline adenoma), low-risk (1–2 adenomas |
| doi_str_mv | 10.1136/gut.2010.232876 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_896223898</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4014323711</sourcerecordid><originalsourceid>FETCH-LOGICAL-b526t-9d322a3818764920584e7f65a44c1c569e77e7c1020d4eb8f49b74a1e5ffa5e93</originalsourceid><addsrcrecordid>eNqFkUFv1DAQhSMEotvCmRuyhFARUlrbcWKnN1hRQFQgpNIDF2viOMXbJA62U7F_iV_JrLIUiQNcbM3M56fneVn2hNETxorq9HpOJ5xixQuuZHUvWzFRqRwLdT9bUcpkXkpRH2SHMW4opUrV7GF2wJngklO6yn6eu1ubby0EEly8IZ0PBNpbGI1tifG9D9Yk6Mlo_dRDdECgSzYQN7rksL9DRh-Nn7YEjPGhdeM1SZ6kb5Y0EG3vRrtIxxQguc4ZPP14RoBMwccJ9dECTud2i7KEi5ITiNthSn5A1JAPaALG-Ch70EEf7eP9fZR9OX9zuX6XX3x6-3796iJvSl6lvG4LzqFQDPchak5LJazsqhKEMMyUVW2ltNIwymkrbKM6UTdSALNl10Fp6-IoO1500d732cakBxeN7XvAJcxRq7rivFC1QvLFP0kmywLj4IIi-uwvdOPnMOI_kJJ1UdKq2gmeLpTBzcRgOz0FN0DYakb1LnCNgetd4HoJHF883evOzWDbO_53wgg83wMQDfRdwGhd_MOJihZKMeTyhXMx2R93cwg3upKFLPXHq7W-fM25kJ-v9FfkXy58M2z-6_IXeLbRnw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1779350668</pqid></control><display><type>article</type><title>Five-year risk for advanced colorectal neoplasia after initial colonoscopy according to the baseline risk stratification: a prospective study in 2452 asymptomatic Koreans</title><source>MEDLINE</source><source>PubMed (Medline)</source><source>BMJ Journals Online Archive</source><creator>Chung, Su Jin ; Kim, Young Sun ; Yang, Sun Young ; Song, Ji Hyun ; Kim, Donghee ; Park, Min Jung ; Kim, Sang Gyun ; Song, In Sung ; Kim, Joo Sung</creator><creatorcontrib>Chung, Su Jin ; Kim, Young Sun ; Yang, Sun Young ; Song, Ji Hyun ; Kim, Donghee ; Park, Min Jung ; Kim, Sang Gyun ; Song, In Sung ; Kim, Joo Sung</creatorcontrib><description>ObjectivePostpolypectomy surveillance guidelines for colorectal cancer introduced the concept of ‘risk stratification’; however, few studies have been conducted for validation of its usefulness. The aim of this study was to assess the 5-year incidence of advanced neoplasia recurrence based on the risk stratification scheme of the guidelines and to identify its risk factors.MethodsA prospective study of surveillance colonoscopy after screening colonoscopy was carried out at the Seoul National University Hospital Healthcare System Gangnam Center. 3803 asymptomatic Koreans aged 50–69 were enrolled prospectively and 5-year cumulative adenoma rates were analysed according to three risk groups: normal (no baseline adenoma), low-risk (1–2 adenomas <10 mm) and high-risk (an advanced adenoma or ≥3 adenomas) groups. The RR was computed by HR using Cox proportional regression after multivariate adjustments. The primary outcome was the 5-year cumulative rate of recurrent advanced adenoma in each risk category and the secondary outcome was its predictive factors.ResultsAmong 3803 subjects enrolled between 2003 and 2005, 2452 were followed-up within 5 years: 1242, 671 and 539 in the normal, low-risk and high-risk groups, respectively. Compared with the normal group, the low-risk group had a sufficiently low 5-year incidence and did not show an increased risk for subsequent advanced adenoma (2.4% vs 2.0%, HR=1.14, 95% CI 0.61 to 2.17). Conversely, a significantly higher 5-year rate (12.2%) and early recurrence (4.6, 7.4 and 9.6% at 1, 2 and 3 years) of advanced adenoma were revealed in the high-risk group. Among various patients and adenoma characteristics, only high-risk adenoma (HR=5.95, 95% CI 3.66 to 9.68) along with a number of ≥3 (HR=3.06, 95% CI 1.51 to 6.57) and size ≥10 mm (HR=3.02, 95% CI 1.80 to 5.06) were independent predictors.ConclusionsThe surveillance interval for low-risk patients could be extended beyond 5 years. Colonoscopic surveillance should be targeted to high-risk patients, and 3-year follow-up after initial polypectomy may be appropriate.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gut.2010.232876</identifier><identifier>PMID: 21427200</identifier><identifier>CODEN: GUTTAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Adenoma - epidemiology ; Adenoma - pathology ; Adenoma - surgery ; Adult ; Aged ; Biological and medical sciences ; Colonic Polyps ; colonoscopy ; Colonoscopy - standards ; Colorectal cancer ; Colorectal neoplasia ; Colorectal Neoplasms - epidemiology ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - surgery ; Digestive system. Abdomen ; Endoscopy ; Family medical history ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Guideline Adherence ; Humans ; Incidence ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Mortality ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - pathology ; Population Surveillance ; Practice Guidelines as Topic ; Prospective Studies ; recurrence ; Risk Assessment ; risk factor ; Risk Factors ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Studies ; Surveillance ; Tumors</subject><ispartof>Gut, 2011-11, Vol.60 (11), p.1537-1543</ispartof><rights>2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2011 (c) 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b526t-9d322a3818764920584e7f65a44c1c569e77e7c1020d4eb8f49b74a1e5ffa5e93</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://gut.bmj.com/content/60/11/1537.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://gut.bmj.com/content/60/11/1537.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24603881$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21427200$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chung, Su Jin</creatorcontrib><creatorcontrib>Kim, Young Sun</creatorcontrib><creatorcontrib>Yang, Sun Young</creatorcontrib><creatorcontrib>Song, Ji Hyun</creatorcontrib><creatorcontrib>Kim, Donghee</creatorcontrib><creatorcontrib>Park, Min Jung</creatorcontrib><creatorcontrib>Kim, Sang Gyun</creatorcontrib><creatorcontrib>Song, In Sung</creatorcontrib><creatorcontrib>Kim, Joo Sung</creatorcontrib><title>Five-year risk for advanced colorectal neoplasia after initial colonoscopy according to the baseline risk stratification: a prospective study in 2452 asymptomatic Koreans</title><title>Gut</title><addtitle>Gut</addtitle><description>ObjectivePostpolypectomy surveillance guidelines for colorectal cancer introduced the concept of ‘risk stratification’; however, few studies have been conducted for validation of its usefulness. The aim of this study was to assess the 5-year incidence of advanced neoplasia recurrence based on the risk stratification scheme of the guidelines and to identify its risk factors.MethodsA prospective study of surveillance colonoscopy after screening colonoscopy was carried out at the Seoul National University Hospital Healthcare System Gangnam Center. 3803 asymptomatic Koreans aged 50–69 were enrolled prospectively and 5-year cumulative adenoma rates were analysed according to three risk groups: normal (no baseline adenoma), low-risk (1–2 adenomas <10 mm) and high-risk (an advanced adenoma or ≥3 adenomas) groups. The RR was computed by HR using Cox proportional regression after multivariate adjustments. The primary outcome was the 5-year cumulative rate of recurrent advanced adenoma in each risk category and the secondary outcome was its predictive factors.ResultsAmong 3803 subjects enrolled between 2003 and 2005, 2452 were followed-up within 5 years: 1242, 671 and 539 in the normal, low-risk and high-risk groups, respectively. Compared with the normal group, the low-risk group had a sufficiently low 5-year incidence and did not show an increased risk for subsequent advanced adenoma (2.4% vs 2.0%, HR=1.14, 95% CI 0.61 to 2.17). Conversely, a significantly higher 5-year rate (12.2%) and early recurrence (4.6, 7.4 and 9.6% at 1, 2 and 3 years) of advanced adenoma were revealed in the high-risk group. Among various patients and adenoma characteristics, only high-risk adenoma (HR=5.95, 95% CI 3.66 to 9.68) along with a number of ≥3 (HR=3.06, 95% CI 1.51 to 6.57) and size ≥10 mm (HR=3.02, 95% CI 1.80 to 5.06) were independent predictors.ConclusionsThe surveillance interval for low-risk patients could be extended beyond 5 years. Colonoscopic surveillance should be targeted to high-risk patients, and 3-year follow-up after initial polypectomy may be appropriate.</description><subject>Adenoma - epidemiology</subject><subject>Adenoma - pathology</subject><subject>Adenoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Colonic Polyps</subject><subject>colonoscopy</subject><subject>Colonoscopy - standards</subject><subject>Colorectal cancer</subject><subject>Colorectal neoplasia</subject><subject>Colorectal Neoplasms - epidemiology</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Family medical history</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Guideline Adherence</subject><subject>Humans</subject><subject>Incidence</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Population Surveillance</subject><subject>Practice Guidelines as Topic</subject><subject>Prospective Studies</subject><subject>recurrence</subject><subject>Risk Assessment</subject><subject>risk factor</subject><subject>Risk Factors</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Studies</subject><subject>Surveillance</subject><subject>Tumors</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkUFv1DAQhSMEotvCmRuyhFARUlrbcWKnN1hRQFQgpNIDF2viOMXbJA62U7F_iV_JrLIUiQNcbM3M56fneVn2hNETxorq9HpOJ5xixQuuZHUvWzFRqRwLdT9bUcpkXkpRH2SHMW4opUrV7GF2wJngklO6yn6eu1ubby0EEly8IZ0PBNpbGI1tifG9D9Yk6Mlo_dRDdECgSzYQN7rksL9DRh-Nn7YEjPGhdeM1SZ6kb5Y0EG3vRrtIxxQguc4ZPP14RoBMwccJ9dECTud2i7KEi5ITiNthSn5A1JAPaALG-Ch70EEf7eP9fZR9OX9zuX6XX3x6-3796iJvSl6lvG4LzqFQDPchak5LJazsqhKEMMyUVW2ltNIwymkrbKM6UTdSALNl10Fp6-IoO1500d732cakBxeN7XvAJcxRq7rivFC1QvLFP0kmywLj4IIi-uwvdOPnMOI_kJJ1UdKq2gmeLpTBzcRgOz0FN0DYakb1LnCNgetd4HoJHF883evOzWDbO_53wgg83wMQDfRdwGhd_MOJihZKMeTyhXMx2R93cwg3upKFLPXHq7W-fM25kJ-v9FfkXy58M2z-6_IXeLbRnw</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>Chung, Su Jin</creator><creator>Kim, Young Sun</creator><creator>Yang, Sun Young</creator><creator>Song, Ji Hyun</creator><creator>Kim, Donghee</creator><creator>Park, Min Jung</creator><creator>Kim, Sang Gyun</creator><creator>Song, In Sung</creator><creator>Kim, Joo Sung</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20111101</creationdate><title>Five-year risk for advanced colorectal neoplasia after initial colonoscopy according to the baseline risk stratification: a prospective study in 2452 asymptomatic Koreans</title><author>Chung, Su Jin ; Kim, Young Sun ; Yang, Sun Young ; Song, Ji Hyun ; Kim, Donghee ; Park, Min Jung ; Kim, Sang Gyun ; Song, In Sung ; Kim, Joo Sung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b526t-9d322a3818764920584e7f65a44c1c569e77e7c1020d4eb8f49b74a1e5ffa5e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adenoma - epidemiology</topic><topic>Adenoma - pathology</topic><topic>Adenoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Colonic Polyps</topic><topic>colonoscopy</topic><topic>Colonoscopy - standards</topic><topic>Colorectal cancer</topic><topic>Colorectal neoplasia</topic><topic>Colorectal Neoplasms - epidemiology</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Family medical history</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Guideline Adherence</topic><topic>Humans</topic><topic>Incidence</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Population Surveillance</topic><topic>Practice Guidelines as Topic</topic><topic>Prospective Studies</topic><topic>recurrence</topic><topic>Risk Assessment</topic><topic>risk factor</topic><topic>Risk Factors</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Studies</topic><topic>Surveillance</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chung, Su Jin</creatorcontrib><creatorcontrib>Kim, Young Sun</creatorcontrib><creatorcontrib>Yang, Sun Young</creatorcontrib><creatorcontrib>Song, Ji Hyun</creatorcontrib><creatorcontrib>Kim, Donghee</creatorcontrib><creatorcontrib>Park, Min Jung</creatorcontrib><creatorcontrib>Kim, Sang Gyun</creatorcontrib><creatorcontrib>Song, In Sung</creatorcontrib><creatorcontrib>Kim, Joo Sung</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chung, Su Jin</au><au>Kim, Young Sun</au><au>Yang, Sun Young</au><au>Song, Ji Hyun</au><au>Kim, Donghee</au><au>Park, Min Jung</au><au>Kim, Sang Gyun</au><au>Song, In Sung</au><au>Kim, Joo Sung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Five-year risk for advanced colorectal neoplasia after initial colonoscopy according to the baseline risk stratification: a prospective study in 2452 asymptomatic Koreans</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>60</volume><issue>11</issue><spage>1537</spage><epage>1543</epage><pages>1537-1543</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><coden>GUTTAK</coden><abstract>ObjectivePostpolypectomy surveillance guidelines for colorectal cancer introduced the concept of ‘risk stratification’; however, few studies have been conducted for validation of its usefulness. The aim of this study was to assess the 5-year incidence of advanced neoplasia recurrence based on the risk stratification scheme of the guidelines and to identify its risk factors.MethodsA prospective study of surveillance colonoscopy after screening colonoscopy was carried out at the Seoul National University Hospital Healthcare System Gangnam Center. 3803 asymptomatic Koreans aged 50–69 were enrolled prospectively and 5-year cumulative adenoma rates were analysed according to three risk groups: normal (no baseline adenoma), low-risk (1–2 adenomas <10 mm) and high-risk (an advanced adenoma or ≥3 adenomas) groups. The RR was computed by HR using Cox proportional regression after multivariate adjustments. The primary outcome was the 5-year cumulative rate of recurrent advanced adenoma in each risk category and the secondary outcome was its predictive factors.ResultsAmong 3803 subjects enrolled between 2003 and 2005, 2452 were followed-up within 5 years: 1242, 671 and 539 in the normal, low-risk and high-risk groups, respectively. Compared with the normal group, the low-risk group had a sufficiently low 5-year incidence and did not show an increased risk for subsequent advanced adenoma (2.4% vs 2.0%, HR=1.14, 95% CI 0.61 to 2.17). Conversely, a significantly higher 5-year rate (12.2%) and early recurrence (4.6, 7.4 and 9.6% at 1, 2 and 3 years) of advanced adenoma were revealed in the high-risk group. Among various patients and adenoma characteristics, only high-risk adenoma (HR=5.95, 95% CI 3.66 to 9.68) along with a number of ≥3 (HR=3.06, 95% CI 1.51 to 6.57) and size ≥10 mm (HR=3.02, 95% CI 1.80 to 5.06) were independent predictors.ConclusionsThe surveillance interval for low-risk patients could be extended beyond 5 years. Colonoscopic surveillance should be targeted to high-risk patients, and 3-year follow-up after initial polypectomy may be appropriate.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>21427200</pmid><doi>10.1136/gut.2010.232876</doi><tpages>7</tpages></addata></record> |
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| subjects | Adenoma - epidemiology Adenoma - pathology Adenoma - surgery Adult Aged Biological and medical sciences Colonic Polyps colonoscopy Colonoscopy - standards Colorectal cancer Colorectal neoplasia Colorectal Neoplasms - epidemiology Colorectal Neoplasms - pathology Colorectal Neoplasms - surgery Digestive system. Abdomen Endoscopy Family medical history Female Gastroenterology. Liver. Pancreas. Abdomen Guideline Adherence Humans Incidence Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Mortality Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - pathology Population Surveillance Practice Guidelines as Topic Prospective Studies recurrence Risk Assessment risk factor Risk Factors Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Studies Surveillance Tumors |
| title | Five-year risk for advanced colorectal neoplasia after initial colonoscopy according to the baseline risk stratification: a prospective study in 2452 asymptomatic Koreans |
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