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A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy.
Gastroenterology. 2009 Mar; 136(3):832-41.G

Abstract

BACKGROUND & AIMS

Limited data exist regarding the actual risk of developing advanced adenomas and cancer after polypectomy or the factors that determine risk.

METHODS

We pooled individual data from 8 prospective studies comprising 9167 men and women aged 22 to 80 with previously resected colorectal adenomas to quantify their risk of developing subsequent advanced adenoma or cancer as well as identify factors associated with the development of advanced colorectal neoplasms during surveillance.

RESULTS

During a median follow-up period of 47.2 months, advanced colorectal neoplasia was diagnosed in 1082 (11.8%) of the patients, 58 of whom (0.6%) had invasive cancer. Risk of a metachronous advanced adenoma was higher among patients with 5 or more baseline adenomas (24.1%; standard error, 2.2) and those with an adenoma 20 mm in size or greater (19.3%; standard error, 1.5). Risk factor patterns were similar for advanced adenomas and invasive cancer. In multivariate analyses, older age (P < .0001 for trend) and male sex (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.19-1.65) were associated significantly with an increased risk for metachronous advanced neoplasia, as were the number and size of prior adenomas (P < .0001 for trend), the presence of villous features (OR, 1.28; 95% CI, 1.07-1.52), and proximal location (OR, 1.68; 95% CI, 1.43-1.98). High-grade dysplasia was not associated independently with metachronous advanced neoplasia after adjustment for other adenoma characteristics.

CONCLUSIONS

Occurrence of advanced colorectal neoplasia is common after polypectomy. Factors that are associated most strongly with risk of advanced neoplasia are patient age and the number and size of prior adenomas.

Authors+Show Affiliations

Arizona Cancer Center, University of Arizona, Tucson, Arizona, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

19171141

Citation

Martínez, María Elena, et al. "A Pooled Analysis of Advanced Colorectal Neoplasia Diagnoses After Colonoscopic Polypectomy." Gastroenterology, vol. 136, no. 3, 2009, pp. 832-41.
Martínez ME, Baron JA, Lieberman DA, et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology. 2009;136(3):832-41.
Martínez, M. E., Baron, J. A., Lieberman, D. A., Schatzkin, A., Lanza, E., Winawer, S. J., Zauber, A. G., Jiang, R., Ahnen, D. J., Bond, J. H., Church, T. R., Robertson, D. J., Smith-Warner, S. A., Jacobs, E. T., Alberts, D. S., & Greenberg, E. R. (2009). A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology, 136(3), 832-41. https://doi.org/10.1053/j.gastro.2008.12.007
Martínez ME, et al. A Pooled Analysis of Advanced Colorectal Neoplasia Diagnoses After Colonoscopic Polypectomy. Gastroenterology. 2009;136(3):832-41. PubMed PMID: 19171141.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. AU - Martínez,María Elena, AU - Baron,John A, AU - Lieberman,David A, AU - Schatzkin,Arthur, AU - Lanza,Elaine, AU - Winawer,Sidney J, AU - Zauber,Ann G, AU - Jiang,Ruiyun, AU - Ahnen,Dennis J, AU - Bond,John H, AU - Church,Timothy R, AU - Robertson,Douglas J, AU - Smith-Warner,Stephanie A, AU - Jacobs,Elizabeth T, AU - Alberts,David S, AU - Greenberg,E Robert, Y1 - 2008/12/09/ PY - 2008/08/08/received PY - 2008/11/12/revised PY - 2008/12/01/accepted PY - 2009/1/28/entrez PY - 2009/1/28/pubmed PY - 2009/4/8/medline SP - 832 EP - 41 JF - Gastroenterology JO - Gastroenterology VL - 136 IS - 3 N2 - BACKGROUND & AIMS: Limited data exist regarding the actual risk of developing advanced adenomas and cancer after polypectomy or the factors that determine risk. METHODS: We pooled individual data from 8 prospective studies comprising 9167 men and women aged 22 to 80 with previously resected colorectal adenomas to quantify their risk of developing subsequent advanced adenoma or cancer as well as identify factors associated with the development of advanced colorectal neoplasms during surveillance. RESULTS: During a median follow-up period of 47.2 months, advanced colorectal neoplasia was diagnosed in 1082 (11.8%) of the patients, 58 of whom (0.6%) had invasive cancer. Risk of a metachronous advanced adenoma was higher among patients with 5 or more baseline adenomas (24.1%; standard error, 2.2) and those with an adenoma 20 mm in size or greater (19.3%; standard error, 1.5). Risk factor patterns were similar for advanced adenomas and invasive cancer. In multivariate analyses, older age (P < .0001 for trend) and male sex (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.19-1.65) were associated significantly with an increased risk for metachronous advanced neoplasia, as were the number and size of prior adenomas (P < .0001 for trend), the presence of villous features (OR, 1.28; 95% CI, 1.07-1.52), and proximal location (OR, 1.68; 95% CI, 1.43-1.98). High-grade dysplasia was not associated independently with metachronous advanced neoplasia after adjustment for other adenoma characteristics. CONCLUSIONS: Occurrence of advanced colorectal neoplasia is common after polypectomy. Factors that are associated most strongly with risk of advanced neoplasia are patient age and the number and size of prior adenomas. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/19171141/A_pooled_analysis_of_advanced_colorectal_neoplasia_diagnoses_after_colonoscopic_polypectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(08)02182-3 DB - PRIME DP - Unbound Medicine ER -