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Three-year colonoscopy surveillance after polypectomy in Korea: A Korean Association for the Study of Intestinal Diseases (KASID) multicenter prospective studyopen access

Authors
Choi W.S.Han D.S.Eun C.S.Park D.I.Byeon J.-S.Yang D.-H.Jung S.-A.Lee S.K.Hong S.P.Park C.H.Lee S.-H.Ji J.-S.Shin S.J.Keum B.Kim H.S.Choi J.H.Jung S.-H.
Issue Date
2018
Publisher
Korean Association for the Study of Intestinal Diseases
Keywords
Adenoma; Colonic polyps; Colonoscopy; Recurrence; Surveillance
Citation
Intestinal Research, v.16, no.1, pp.126 - 133
Indexed
SCOPUS
KCI
Journal Title
Intestinal Research
Volume
16
Number
1
Start Page
126
End Page
133
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/4200
DOI
10.5217/ir.2018.16.1.126
ISSN
1598-9100
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. © 2018. Korean Association for the Study of Intestinal Diseases.
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