Colorectal cancer risk following polypectomy in a multicenter, retrospective, cohort study: An evaluation of the 2020 UK post-polypectomy surveillance guidelines
Gut — Cross AJ, Robbins EC, Pack K, et al. | November 09, 2021
This evaluation of the 2020 UK post-polypectomy surveillance guidelines revealed that these guidelines allow precise classification of post-polypectomy cases into those carrying a high risk for colorectal cancer (CRC) development, for whom one surveillance colonoscopy seems suitable, and those at low risk who can be managed via non-invasive screening.
Colonoscopy surveillance intends to decrease CRC incidence post-polypectomy.
The 2020 UK post-polypectomy surveillance guidelines were evaluated in this retrospective study of patients who had colonoscopy and polypectomy mostly between 2000 and 2010 at 17 UK hospitals, observed through 2017.
In 21,318 cases, 368 CRCs occurred during the observation period (median: 10.1 years).
Age ≥55 years, ≥2 premalignant polyps (PMPs), adenomas with tubulovillous/villous/unknown histology or high-grade dysplasia, proximal polyps and a baseline visit spanning 2–90 days were the baseline CRC risk factors identified.
Relative to the general population, a higher CRC incidence without surveillance was noted in those with adenomas with high-grade dysplasia (standardized incidence ratio SIR: 1.74) or ≥2 PMPs, of which ≥1 was advanced (1.39).
SIRs without surveillance were 0.75 and 1.30, respectively, for low-risk (71%) and high-risk (29%) patients; the SIR was 1.22 for high-risk patients post-first surveillance.
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