Surveillance Interval of Patients with High-Risk Adenomas Removed during Screening Colonoscopy
Invited conference paper presented and published in conference proceedings
CUHK Authors
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AbstractIntroduction: Evidence of recommendation of surveillance interval after removal of high-risk adenomas at screening colonoscopy is limited.Aims & Methods: To determine whether the risk of metachronous ad-vanced neoplasia (AN) increases if surveillance interval was beyond the current recommendation of 3 years for high-risk patients identified at screening colonoscopy.Patients with high-risk adenoma removed during colonoscopy were iden-tified from the cohort of an existing territory wide colorectal cancer (CRC) screening programme and open recruitment. High-risk adenomas were advanced adenoma (AA) (defined as size ≥1 cm, with tubulovillous or vil-lous components, or with high-grade dysplasia) or ≥3 non-AA. High-risk patients who had baseline screening colonoscopy done in ≤3-year and >3-years and due for surveillance colonoscopy, were recruited and ar-ranged for surveillance colonoscopy. Primary outcome was AN (AA or CRC) detection rate. Secondary outcome was overall adenoma detection rate.Results: 90 eligible patients were recruited in ≤3-year group and 90 in >3-year group. 63.9% of them were male and their mean age was 59.4 (5.8). Patients in >3-year group had higher risk of metachronous AN than those in ≤3-year group (8.9% vs 4.4%) but without statistical significance (p=0.232). There was one CRC case found in >3-year group. Similar results were observed in ≥3 adenoma detection (13.3% vs 6.7%, p=0.136). How-ever, the overall adenoma detection rate (ADR) of >3-year group was sig-nificantly higher (67.8% vs 46.7%, p=0.004).Conclusion: Patients with high-risk adenoma at baseline screening had a higher ADR and might have a higher risk to metachronous AN if the surveil-lance interval was >3-year. The study results suggest that a shorter surveil-lance period is warranted.
All Author(s) ListThomas Y.T. Lam, Raymond Tang, Joseph J.Y. Sung
Name of ConferenceUnited European Digestive Disease Week 2021
Start Date of Conference08/10/2021
End Date of Conference11/10/2021
Place of ConferenceVienna
Country/Region of ConferenceAustria
Year2021
LanguagesEnglish-United States