Three-year colonoscopy surveillance after polypectomy in Korea: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter prospective study
- Author:
Won Seok CHOI
1
;
Dong Soo HAN
;
Chang Soo EUN
;
Dong Il PARK
;
Jeong Sik BYEON
;
Dong Hoon YANG
;
Sung Ae JUNG
;
Sang Kil LEE
;
Sung Pil HONG
;
Cheol Hee PARK
;
Suck Ho LEE
;
Jeong Seon JI
;
Sung Jae SHIN
;
Bora KEUM
;
Hyun Soo KIM
;
Jung Hye CHOI
;
Sin Ho JUNG
Author Information
- Publication Type:Multicenter Study
- Keywords: Colonoscopy; Colonic polyps; Surveillance; Recurrence; Adenoma
- MeSH: Adenoma; Asia; Colon; Colonic Polyps; Colonoscopy; Follow-Up Studies; Humans; Incidence; Korea; Male; Prospective Studies; Recurrence; Risk Factors
- From:Intestinal Research 2018;16(1):126-133
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Colonoscopic surveillance is currently recommended after polypectomy owing to the risk of newly developed colonic neoplasia. However, few studies have investigated colonoscopy surveillance in Asia. This multicenter and prospective study was undertaken to assess the incidence of advanced adenoma based on baseline adenoma findings at 3 years after colonoscopic polypectomy. METHODS: A total of 1,323 patients undergoing colonoscopic polypectomy were prospectively assigned to 3-year colonoscopy surveillance at 11 tertiary endoscopic centers. Relative risks for advanced adenoma after 3 years were calculated according to baseline adenoma characteristics. RESULTS: Among 1,323 patients enrolled, 387 patients (29.3%) were followed up, and the mean follow-up interval was 31.0±9.8 months. The percentage of patients with advanced adenoma on baseline colonoscopy was higher in the surveillance group compared to the non-surveillance group (34.4% vs. 25.7%). Advanced adenoma recurrence was observed in 17 patients (4.4%) at follow-up. The risk of advanced adenoma recurrence was 2 times greater in patients with baseline advanced adenoma than in those with baseline non-advanced adenoma, though the difference was not statistically significant (6.8% [9/133] vs. 3.1% [8/254], P=0.09). Advanced adenoma recurrence was observed only in males and in subjects aged ≥50 years. In contrast, adenoma recurrence was observed in 187 patients (48.3%) at follow-up. Male sex, older age (≥50 years), and multiple adenomas (≥3) at baseline were independent risk factors for adenoma recurrence. CONCLUSIONS: A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.
