Risk of advanced lesions at first follow-up colonoscopy in high-risk groups as defined by the United Kingdom post-polypectomy surveillance guideline

Data from a single U.S. Center

Krishna C. Vemulapalli, Douglas Rex

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background The United Kingdom (U.K.) post-adenoma resection guidelines recommend earlier surveillance for patients with 5 or more adenomas or 3 to 4 adenomas of which one is 10 mm or larger compared with U.S. guidelines. Objective To evaluate the effect of using the U.K. guideline on a U.S. cohort of adenoma patients. Design Single-center, retrospective study. Setting Indiana University Hospital and an associated ambulatory surgery center. Patients A total of 1414 patients with baseline adenoma findings belonging to one of 5 risk categories and with a follow-up colonoscopy more than 200 days later. Intervention Colonoscopy, polypectomy. Main Outcome Measurements Incidence of advanced lesions at follow-up colonoscopy. Results Advanced neoplasms at follow-up occurred in 16.3% of patients with 5 or more adenomas including 1 that was 10 mm or larger, 8.6% of patients with 3 or 4 adenomas including 1 that was 10 mm or larger, 5% of those with 5 or more adenomas all smaller than 10 mm, 1.8% of those with 3 or 4 adenomas all smaller than 10 mm, and 1.4% of those with 1 to 2 adenomas smaller than 10 mm. Logistic regression analyses showed that the rate of advanced lesions at first follow-up was increased in persons with 3 or more baseline adenomas and at least 1 that is 10 mm or larger compared with those with 1 to 4 small baseline adenomas. Limitations Single-center, retrospective study. Conclusions Our results indicate the U.K. guideline predicts higher risk groups for advanced neoplasia at first follow-up. Our study had inadequate power to show better prediction of incident cancer. Additional study of other databases is warranted.

Original languageEnglish
Pages (from-to)299-306
Number of pages8
JournalGastrointestinal Endoscopy
Volume80
Issue number2
DOIs
StatePublished - 2014

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Colonoscopy
Adenoma
Guidelines
United Kingdom
Retrospective Studies
Neoplasms
Ambulatory Surgical Procedures
Logistic Models
Regression Analysis
Databases

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

@article{7783a54ec9474315bb7e56485a4fd79e,
title = "Risk of advanced lesions at first follow-up colonoscopy in high-risk groups as defined by the United Kingdom post-polypectomy surveillance guideline: Data from a single U.S. Center",
abstract = "Background The United Kingdom (U.K.) post-adenoma resection guidelines recommend earlier surveillance for patients with 5 or more adenomas or 3 to 4 adenomas of which one is 10 mm or larger compared with U.S. guidelines. Objective To evaluate the effect of using the U.K. guideline on a U.S. cohort of adenoma patients. Design Single-center, retrospective study. Setting Indiana University Hospital and an associated ambulatory surgery center. Patients A total of 1414 patients with baseline adenoma findings belonging to one of 5 risk categories and with a follow-up colonoscopy more than 200 days later. Intervention Colonoscopy, polypectomy. Main Outcome Measurements Incidence of advanced lesions at follow-up colonoscopy. Results Advanced neoplasms at follow-up occurred in 16.3{\%} of patients with 5 or more adenomas including 1 that was 10 mm or larger, 8.6{\%} of patients with 3 or 4 adenomas including 1 that was 10 mm or larger, 5{\%} of those with 5 or more adenomas all smaller than 10 mm, 1.8{\%} of those with 3 or 4 adenomas all smaller than 10 mm, and 1.4{\%} of those with 1 to 2 adenomas smaller than 10 mm. Logistic regression analyses showed that the rate of advanced lesions at first follow-up was increased in persons with 3 or more baseline adenomas and at least 1 that is 10 mm or larger compared with those with 1 to 4 small baseline adenomas. Limitations Single-center, retrospective study. Conclusions Our results indicate the U.K. guideline predicts higher risk groups for advanced neoplasia at first follow-up. Our study had inadequate power to show better prediction of incident cancer. Additional study of other databases is warranted.",
author = "Vemulapalli, {Krishna C.} and Douglas Rex",
year = "2014",
doi = "10.1016/j.gie.2014.02.1029",
language = "English",
volume = "80",
pages = "299--306",
journal = "Gastrointestinal Endoscopy",
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T1 - Risk of advanced lesions at first follow-up colonoscopy in high-risk groups as defined by the United Kingdom post-polypectomy surveillance guideline

T2 - Data from a single U.S. Center

AU - Vemulapalli, Krishna C.

AU - Rex, Douglas

PY - 2014

Y1 - 2014

N2 - Background The United Kingdom (U.K.) post-adenoma resection guidelines recommend earlier surveillance for patients with 5 or more adenomas or 3 to 4 adenomas of which one is 10 mm or larger compared with U.S. guidelines. Objective To evaluate the effect of using the U.K. guideline on a U.S. cohort of adenoma patients. Design Single-center, retrospective study. Setting Indiana University Hospital and an associated ambulatory surgery center. Patients A total of 1414 patients with baseline adenoma findings belonging to one of 5 risk categories and with a follow-up colonoscopy more than 200 days later. Intervention Colonoscopy, polypectomy. Main Outcome Measurements Incidence of advanced lesions at follow-up colonoscopy. Results Advanced neoplasms at follow-up occurred in 16.3% of patients with 5 or more adenomas including 1 that was 10 mm or larger, 8.6% of patients with 3 or 4 adenomas including 1 that was 10 mm or larger, 5% of those with 5 or more adenomas all smaller than 10 mm, 1.8% of those with 3 or 4 adenomas all smaller than 10 mm, and 1.4% of those with 1 to 2 adenomas smaller than 10 mm. Logistic regression analyses showed that the rate of advanced lesions at first follow-up was increased in persons with 3 or more baseline adenomas and at least 1 that is 10 mm or larger compared with those with 1 to 4 small baseline adenomas. Limitations Single-center, retrospective study. Conclusions Our results indicate the U.K. guideline predicts higher risk groups for advanced neoplasia at first follow-up. Our study had inadequate power to show better prediction of incident cancer. Additional study of other databases is warranted.

AB - Background The United Kingdom (U.K.) post-adenoma resection guidelines recommend earlier surveillance for patients with 5 or more adenomas or 3 to 4 adenomas of which one is 10 mm or larger compared with U.S. guidelines. Objective To evaluate the effect of using the U.K. guideline on a U.S. cohort of adenoma patients. Design Single-center, retrospective study. Setting Indiana University Hospital and an associated ambulatory surgery center. Patients A total of 1414 patients with baseline adenoma findings belonging to one of 5 risk categories and with a follow-up colonoscopy more than 200 days later. Intervention Colonoscopy, polypectomy. Main Outcome Measurements Incidence of advanced lesions at follow-up colonoscopy. Results Advanced neoplasms at follow-up occurred in 16.3% of patients with 5 or more adenomas including 1 that was 10 mm or larger, 8.6% of patients with 3 or 4 adenomas including 1 that was 10 mm or larger, 5% of those with 5 or more adenomas all smaller than 10 mm, 1.8% of those with 3 or 4 adenomas all smaller than 10 mm, and 1.4% of those with 1 to 2 adenomas smaller than 10 mm. Logistic regression analyses showed that the rate of advanced lesions at first follow-up was increased in persons with 3 or more baseline adenomas and at least 1 that is 10 mm or larger compared with those with 1 to 4 small baseline adenomas. Limitations Single-center, retrospective study. Conclusions Our results indicate the U.K. guideline predicts higher risk groups for advanced neoplasia at first follow-up. Our study had inadequate power to show better prediction of incident cancer. Additional study of other databases is warranted.

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