Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?

Background/Aims: Western surveillance strategies cannot be directly adapted to the Korean population. The aim of this study was to estimate the risk of metachronous neoplasia and the optimal surveillance interval in the Korean population.Methods: Clinical and pathological data from index colonoscopy...

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Main Authors: Jung Lok Lee, Jae Myung Cha, Hye Min Lee, Jung Won Jeon, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Dong Il Park
Format: Article
Language:English
Published: Korean Association for the Study of Intestinal Diseases 2017-01-01
Series:Intestinal Research
Subjects:
Online Access:https://doi.org/10.5217/ir.2017.15.1.109
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author Jung Lok Lee
Jae Myung Cha
Hye Min Lee
Jung Won Jeon
Min Seob Kwak
Jin Young Yoon
Hyun Phil Shin
Kwang Ro Joo
Joung Il Lee
Dong Il Park
author_facet Jung Lok Lee
Jae Myung Cha
Hye Min Lee
Jung Won Jeon
Min Seob Kwak
Jin Young Yoon
Hyun Phil Shin
Kwang Ro Joo
Joung Il Lee
Dong Il Park
author_sort Jung Lok Lee
collection DOAJ
description Background/Aims: Western surveillance strategies cannot be directly adapted to the Korean population. The aim of this study was to estimate the risk of metachronous neoplasia and the optimal surveillance interval in the Korean population.Methods: Clinical and pathological data from index colonoscopy performed between June 2006 and July 2008 and who had surveillance colonoscopies up to May 2015 were compared between low- and high-risk adenoma (LRA and HRA) groups. The 3- and 5-year cumulative risk of metachronous colorectal neoplasia in both groups were compared.Results: Among 895 eligible patients, surveillance colonoscopy was performed in 399 (44.6%). Most (83.3%) patients with LRA had a surveillance colonoscopy within 5 years and 70.2% of patients with HRA had a surveillance colonoscopy within 3 years. The cumulative risk of metachronous advanced adenoma was 3.2% within 5 years in the LRA group and only 1.7% within 3 years in the HRA group. The risk of metachronous neoplasia was similar between the surveillance interval of <5 and ≥5 years in the LRA group; however, it was slightly higher at surveillance interval of ≥3 than <3 years in the HRA group (9.4% vs. 2.4%). In multivariate analysis, age and the ≥3-year surveillance interval were significant independent risk factors for metachronous advanced adenoma (P=0.024 and P=0.030, respectively).Conclusions: Patients had a surveillance colonoscopy before the recommended guidelines despite a low risk of metachronous neoplasia. However, the risk of metachronous advanced adenoma was increased in elderly patients and those with a ≥3-year surveillance interval.
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spelling doaj.art-3637c6b478fc46269cfcd2ebc762f82f2022-12-22T00:13:11ZengKorean Association for the Study of Intestinal DiseasesIntestinal Research1598-91002017-01-0115110911710.5217/ir.2017.15.1.109ir.2017.15.1.109Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?Jung Lok Lee0Jae Myung Cha1Hye Min Lee2Jung Won Jeon3Min Seob Kwak4Jin Young Yoon5Hyun Phil Shin6Kwang Ro Joo7Joung Il Lee8Dong Il Park9Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.Background/Aims: Western surveillance strategies cannot be directly adapted to the Korean population. The aim of this study was to estimate the risk of metachronous neoplasia and the optimal surveillance interval in the Korean population.Methods: Clinical and pathological data from index colonoscopy performed between June 2006 and July 2008 and who had surveillance colonoscopies up to May 2015 were compared between low- and high-risk adenoma (LRA and HRA) groups. The 3- and 5-year cumulative risk of metachronous colorectal neoplasia in both groups were compared.Results: Among 895 eligible patients, surveillance colonoscopy was performed in 399 (44.6%). Most (83.3%) patients with LRA had a surveillance colonoscopy within 5 years and 70.2% of patients with HRA had a surveillance colonoscopy within 3 years. The cumulative risk of metachronous advanced adenoma was 3.2% within 5 years in the LRA group and only 1.7% within 3 years in the HRA group. The risk of metachronous neoplasia was similar between the surveillance interval of <5 and ≥5 years in the LRA group; however, it was slightly higher at surveillance interval of ≥3 than <3 years in the HRA group (9.4% vs. 2.4%). In multivariate analysis, age and the ≥3-year surveillance interval were significant independent risk factors for metachronous advanced adenoma (P=0.024 and P=0.030, respectively).Conclusions: Patients had a surveillance colonoscopy before the recommended guidelines despite a low risk of metachronous neoplasia. However, the risk of metachronous advanced adenoma was increased in elderly patients and those with a ≥3-year surveillance interval.https://doi.org/10.5217/ir.2017.15.1.109Colorectal neoplasmsSurveillanceGuidelineColonoscopyPolypectomy
spellingShingle Jung Lok Lee
Jae Myung Cha
Hye Min Lee
Jung Won Jeon
Min Seob Kwak
Jin Young Yoon
Hyun Phil Shin
Kwang Ro Joo
Joung Il Lee
Dong Il Park
Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
Intestinal Research
Colorectal neoplasms
Surveillance
Guideline
Colonoscopy
Polypectomy
title Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
title_full Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
title_fullStr Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
title_full_unstemmed Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
title_short Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
title_sort determining the optimal surveillance interval after a colonoscopic polypectomy for the korean population
topic Colorectal neoplasms
Surveillance
Guideline
Colonoscopy
Polypectomy
url https://doi.org/10.5217/ir.2017.15.1.109
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