Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies.
Risk stratification by index colonoscopy is well established for first surveillance endoscopy, but whether the previous two colonoscopies affect the subsequent advanced neoplasias has not been established. Therefore, the subsequent risk based on the findings of the index and first surveillance colon...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0245211 |
| _version_ | 1828923102455660544 |
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| author | Munenori Honda Hideaki Naoe Ryosuke Gushima Hideaki Miyamoto Masakuni Tateyama Kouichi Sakurai Yasushi Oda Yoshitaka Murakami Yasuhito Tanaka |
| author_facet | Munenori Honda Hideaki Naoe Ryosuke Gushima Hideaki Miyamoto Masakuni Tateyama Kouichi Sakurai Yasushi Oda Yoshitaka Murakami Yasuhito Tanaka |
| author_sort | Munenori Honda |
| collection | DOAJ |
| description | Risk stratification by index colonoscopy is well established for first surveillance endoscopy, but whether the previous two colonoscopies affect the subsequent advanced neoplasias has not been established. Therefore, the subsequent risk based on the findings of the index and first surveillance colonoscopies were investigated. This retrospective, cohort study was conducted in two clinics and included participants who had undergone two or more colonoscopies after index colonoscopy. High-risk was defined as advanced adenoma (≥ 1 cm, or tubulovillous or villous histology, or high-grade dysplasia). Based on the findings of the index and first surveillance colonoscopies, patients were classified into four categories: category A (both colonoscopy findings were normal), category B (no high-risk findings both times), category C (one time high-risk finding), and category D (high-risk findings both times). The incidence of subsequent advanced neoplasia was examined in each category. A total of 13,426 subjects were included and surveyed during the study periods. The subjects in category D had the highest risk of advanced neoplasia (27.4%, n = 32/117). The subjects in category A had the lowest risk (4.0%, n = 225/5,583). The hazard ratio for advanced neoplasia of category D compared to category A was 9.90 (95% Confidence interval 6.82-14.35, P<0.001). Classification based on the findings of index and first surveillance colonoscopies more effectively stratifies the risk of subsequent advanced neoplasia, resulting in more proper allocation of colonoscopy resources after two consecutive colonoscopies. |
| first_indexed | 2024-12-13T22:34:35Z |
| format | Article |
| id | doaj.art-b497507c08da44a0bd086a12d36a89a6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T22:34:35Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b497507c08da44a0bd086a12d36a89a62022-12-21T23:29:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01161e024521110.1371/journal.pone.0245211Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies.Munenori HondaHideaki NaoeRyosuke GushimaHideaki MiyamotoMasakuni TateyamaKouichi SakuraiYasushi OdaYoshitaka MurakamiYasuhito TanakaRisk stratification by index colonoscopy is well established for first surveillance endoscopy, but whether the previous two colonoscopies affect the subsequent advanced neoplasias has not been established. Therefore, the subsequent risk based on the findings of the index and first surveillance colonoscopies were investigated. This retrospective, cohort study was conducted in two clinics and included participants who had undergone two or more colonoscopies after index colonoscopy. High-risk was defined as advanced adenoma (≥ 1 cm, or tubulovillous or villous histology, or high-grade dysplasia). Based on the findings of the index and first surveillance colonoscopies, patients were classified into four categories: category A (both colonoscopy findings were normal), category B (no high-risk findings both times), category C (one time high-risk finding), and category D (high-risk findings both times). The incidence of subsequent advanced neoplasia was examined in each category. A total of 13,426 subjects were included and surveyed during the study periods. The subjects in category D had the highest risk of advanced neoplasia (27.4%, n = 32/117). The subjects in category A had the lowest risk (4.0%, n = 225/5,583). The hazard ratio for advanced neoplasia of category D compared to category A was 9.90 (95% Confidence interval 6.82-14.35, P<0.001). Classification based on the findings of index and first surveillance colonoscopies more effectively stratifies the risk of subsequent advanced neoplasia, resulting in more proper allocation of colonoscopy resources after two consecutive colonoscopies.https://doi.org/10.1371/journal.pone.0245211 |
| spellingShingle | Munenori Honda Hideaki Naoe Ryosuke Gushima Hideaki Miyamoto Masakuni Tateyama Kouichi Sakurai Yasushi Oda Yoshitaka Murakami Yasuhito Tanaka Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies. PLoS ONE |
| title | Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies. |
| title_full | Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies. |
| title_fullStr | Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies. |
| title_full_unstemmed | Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies. |
| title_short | Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies. |
| title_sort | risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies |
| url | https://doi.org/10.1371/journal.pone.0245211 |
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