Intest Res.  2017 Jan;15(1):109-117. 10.5217/ir.2017.15.1.109.

Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?

• Lee JL
• Cha JM
• Lee HM
• Jeon JW
• Kwak MS
• Yoon JY
• Shin HP
• Joo KR
• Lee JI
• Park DI

• KMID: 2368493
• DOI: http://doi.org/10.5217/ir.2017.15.1.109

Abstract

BACKGROUND/AIMS
Western surveillance strategies cannot be directly adapted to the Korean population. The aim of this study was to estimate the risk of metachronous neoplasia and the optimal surveillance interval in the Korean population.
METHODS
Clinical and pathological data from index colonoscopy performed between June 2006 and July 2008 and who had surveillance colonoscopies up to May 2015 were compared between low- and high-risk adenoma (LRA and HRA) groups. The 3- and 5-year cumulative risk of metachronous colorectal neoplasia in both groups were compared.
RESULTS
Among 895 eligible patients, surveillance colonoscopy was performed in 399 (44.6%). Most (83.3%) patients with LRA had a surveillance colonoscopy within 5 years and 70.2% of patients with HRA had a surveillance colonoscopy within 3 years. The cumulative risk of metachronous advanced adenoma was 3.2% within 5 years in the LRA group and only 1.7% within 3 years in the HRA group. The risk of metachronous neoplasia was similar between the surveillance interval of <5 and ≥5 years in the LRA group; however, it was slightly higher at surveillance interval of ≥3 than <3 years in the HRA group (9.4% vs. 2.4%). In multivariate analysis, age and the ≥3-year surveillance interval were significant independent risk factors for metachronous advanced adenoma (P=0.024 and P=0.030, respectively).
CONCLUSIONS
Patients had a surveillance colonoscopy before the recommended guidelines despite a low risk of metachronous neoplasia. However, the risk of metachronous advanced adenoma was increased in elderly patients and those with a ≥3-year surveillance interval.

Keyword

Colorectal neoplasms; Surveillance; Guideline; Colonoscopy; Polypectomy

MeSH Terms

Adenoma
Aged
Colonoscopy
Colorectal Neoplasms
Humans
Multivariate Analysis
Risk Factors

Figure

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  Fig. 1 Overview of the study design. The study included 895 cohort patients who underwent complete colonoscopic polypectomies. After baseline colonoscopic polypectomy, patients underwent one or more surveillance colonoscopies according to risk stratification of index colonoscopy. The rate of surveillance colonoscopy in the low-risk adenoma (LRA) and high-risk adenoma (HRA) groups were 45.5% and 43.5%, respectively.

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