Five-year colon surveillance after screening colonoscopy.
Gastroenterology
; 133(4): 1077-85, 2007 Oct.
Article
em En
| MEDLINE
| ID: mdl-17698067
ABSTRACT
BACKGROUND & AIMS:
Outcomes of colon surveillance after colorectal cancer screening with colonoscopy are uncertain. We conducted a prospective study to measure incidence of advanced neoplasia in patients within 5.5 years of screening colonoscopy.METHODS:
Three thousand one hundred twenty-one asymptomatic subjects, age 50 to 75 years, had screening colonoscopy between 1994 and 1997 in the Department of Veterans Affairs. One thousand one hundred seventy-one subjects with neoplasia and 501 neoplasia-free controls were assigned to colonoscopic surveillance over 5 years. Cohorts were defined by baseline findings. Relative risks for advanced neoplasia within 5.5 years were calculated. Advanced neoplasia was defined as tubular adenoma greater than > or =10 mm, adenoma with villous histology, adenoma with high-grade dysplasia, or invasive cancer.RESULTS:
Eight hundred ninety-five (76.4%) patients with neoplasia and 298 subjects (59.5%) without neoplasia at baseline had colonoscopy within 5.5 years; 2.4% of patients with no neoplasia had interval advanced neoplasia. The relative risk in patients with baseline neoplasia was 1.92 (95% CI 0.83-4.42) with 1 or 2 tubular adenomas <10 mm, 5.01 (95% CI 2.10-11.96) with 3 or more tubular adenomas <10 mm, 6.40 (95% CI 2.74-14.94) with tubular adenoma > or =10 mm, 6.05 (95% CI 2.48-14.71) for villous adenoma, and 6.87 (95% CI 2.61-18.07) for adenoma with high-grade dysplasia.CONCLUSIONS:
There is a strong association between results of baseline screening colonoscopy and rate of serious incident lesions during 5.5 years of surveillance. Patients with 1 or 2 tubular adenomas less than 10 mm represent a low-risk group compared with other patients with colon neoplasia.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Adenoma
/
Programas de Rastreamento
/
Colonoscopia
Idioma:
En
Ano de publicação:
2007
Tipo de documento:
Article