1. Risk of Colorectal Cancer and Advanced Polyps One Year After Excision of High-Risk Adenomas
- Author
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Medina-Prado L, Mangas-Sanjuan C, Baile-Maxía S, Martínez-Roca A, Murcia O, Zarraquiños S, Rodríguez-Camacho E, Aginagalde AH, Álvarez-Urturi C, Valverde MJ, Zapater P, Bujanda L, Salas D, Portillo I, Pellisé M, Cubiella J, and Jover R
- Subjects
Surveillance ,FIT-screening ,Colonoscopy ,Advanced neoplasia ,Adenomas ,Colorectal cancer ,digestive system diseases - Abstract
BACKGROUND: Patients with multiple or large adenomas are considered as high-risk for metachronous colorectal cancer. OBJECTIVE: Evaluate the risks of detecting colorectal cancer, advanced adenoma, and advanced serrated polyps at one-year surveillance colonoscopy in patients with > 5 adenomas or adenomas > 20 mm. DESIGN: Descriptive, retrospective, multicentric, cohort study. We calculated the absolute risk of developing colorectal cancer, advanced adenomas, and advanced serrated polyps at the one-year surveillance colonoscopy. Potential risk factors for advanced neoplasia at follow-up were evaluated with univariable and multivariable logistic regression analyses. SETTINGS: This study included data from a multicenter cohort colorectal cancer screening program, conducted from January 2014 to December 2015, based on fecal immunochemical tests in Spain. PATIENTS: We included 2119 participants with at least one adenoma =20 mm or =5 adenomas of any size. MAIN OUTCOME MEASURES: We calculated the absolute risk of developing colorectal cancer, advanced adenomas, and advanced serrated polyps at the one-year surveillance colonoscopy. Potential risk factors for advanced neoplasia at follow-up were evaluated with univariable and multivariable logistic regression analyses. RESULTS: At one year, participants displayed 6 colorectal cancers (0.3%), 228 advanced adenomas (10.5%), and 58 advanced serrated polyps (2.7%). The adjusted analysis identified two factors associated with advanced neoplasia: >5 adenomas (odds ratio 1.53; 95% CI: 1.15-2.03; p=0.004) and polyps in a proximal location (odds ratio 1.52; 95% CI: 1.15-2.02; p=0.004). LIMITATIONS: First, the sample size was relatively small compared to other studies with similar aims. Another limitation was the lack of a comparison group, which could have provided more practical results, in terms of surveillance recommendations. CONCLUSION: The colorectal cancer detection rate at a one-year colonoscopy surveillance was low among patients classified at high risk of advanced neoplasia. The risk factors for advanced neoplasia were =5 adenomas and proximal polyps at baseline. See Video Abstract at http://links.lww.com/DCR/B820.
- Published
- 2022