Tags

Type your tag names separated by a space and hit enter

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.
Gastrointest Endosc. 2014 Aug; 80(2):299-306.GE

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.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24796960

Citation

Vemulapalli, Krishna C., and Douglas K. Rex. "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." Gastrointestinal Endoscopy, vol. 80, no. 2, 2014, pp. 299-306.
Vemulapalli KC, Rex DK. 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. Gastrointest Endosc. 2014;80(2):299-306.
Vemulapalli, K. C., & Rex, D. K. (2014). 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. Gastrointestinal Endoscopy, 80(2), 299-306. https://doi.org/10.1016/j.gie.2014.02.1029
Vemulapalli KC, Rex DK. 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. Gastrointest Endosc. 2014;80(2):299-306. PubMed PMID: 24796960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Vemulapalli,Krishna C, AU - Rex,Douglas K, Y1 - 2014/05/03/ PY - 2013/10/08/received PY - 2014/02/27/accepted PY - 2014/5/7/entrez PY - 2014/5/7/pubmed PY - 2015/4/23/medline SP - 299 EP - 306 JF - Gastrointestinal endoscopy JO - Gastrointest Endosc VL - 80 IS - 2 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. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/24796960/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(14)01199-7 DB - PRIME DP - Unbound Medicine ER -