Post-polypectomy colonoscopy surveillance guidelines confirmed
Monday, 29 November 1999 19:00 | 
| Medicexchange News - Medicexchange News |
Results of a new study support 2006 consensus guidelines on post-polypectomy colonoscopy surveillance, which recommend a 3-year follow-up for individuals with three or more small adenoma or an advanced adenoma removed.
Results of a new study support 2006 consensus guidelines on post-polypectomy colonoscopy surveillance, which recommend a 3-year follow-up colonoscopy for individuals who had three or more small adenoma or an advanced adenoma removed.
The study, reported Sunday at the 100th annual meeting of the American Association for Cancer Research in Los Angeles, also finds that three other factors -- age over 65, male gender, and obesity -- independently raise the risk of polyp recurrence.
In a telephone interview, study presenter Dr. Adeyinka O. Laiyemo, a cancer prevention fellow at the National Cancer Institute in Bethesda noted that repeat colonoscopies make up a significant portion of endoscopic practices. The current findings could help physicians further stratify patients at greatest need for follow up colonoscopies.
Dr. Laiyemo and colleagues examined the diet, lifestyle and polyp characteristics that may be associated with recurrence of a high-risk adenoma at surveillance colonoscopy among participants in the Polyp Prevention Trial.
Of 1,905 subjects who had at least one adenoma removed at the baseline colonoscopy, 230 (12.1 per cent) had high-risk adenoma recurrence and 524 (27.5 per cent) had low-risk adenoma recurrence when they were ‘re-scoped.’
In multivariate analysis, having three or more polyps at baseline was associated with a significant 2.5-fold greater likelihood of high-risk adenoma recurrence. "This tells us that the guidelines do predict those patients that are likely to develop high-risk polyps later," Dr. Laiyemo said.
Age older than 65, male gender and obesity also increased the risk of high-risk polyp recurrence, with odds ratios of 1.06, 1.76, and 1.55, respectively.
"Individuals who fit the high-risk profile should be targeted more closely for lifestyle factor modification and be given high priority for surveillance colonoscopy," Dr. Laiyemo and colleagues conclude in meeting materials.
In support of prior studies, use of non-steroidal anti-inflammatory drugs was associated with a statistically significant lower risk of polyp recurrence. "NSAID use reduces the risk of polyp recurrence by about 30 per cent; however, we know that these drugs are not recommended for use for polyp prevention because of side effects," the researchers note.
The study, reported Sunday at the 100th annual meeting of the American Association for Cancer Research in Los Angeles, also finds that three other factors -- age over 65, male gender, and obesity -- independently raise the risk of polyp recurrence.
In a telephone interview, study presenter Dr. Adeyinka O. Laiyemo, a cancer prevention fellow at the National Cancer Institute in Bethesda noted that repeat colonoscopies make up a significant portion of endoscopic practices. The current findings could help physicians further stratify patients at greatest need for follow up colonoscopies.
Dr. Laiyemo and colleagues examined the diet, lifestyle and polyp characteristics that may be associated with recurrence of a high-risk adenoma at surveillance colonoscopy among participants in the Polyp Prevention Trial.
Of 1,905 subjects who had at least one adenoma removed at the baseline colonoscopy, 230 (12.1 per cent) had high-risk adenoma recurrence and 524 (27.5 per cent) had low-risk adenoma recurrence when they were ‘re-scoped.’
In multivariate analysis, having three or more polyps at baseline was associated with a significant 2.5-fold greater likelihood of high-risk adenoma recurrence. "This tells us that the guidelines do predict those patients that are likely to develop high-risk polyps later," Dr. Laiyemo said.
Age older than 65, male gender and obesity also increased the risk of high-risk polyp recurrence, with odds ratios of 1.06, 1.76, and 1.55, respectively.
"Individuals who fit the high-risk profile should be targeted more closely for lifestyle factor modification and be given high priority for surveillance colonoscopy," Dr. Laiyemo and colleagues conclude in meeting materials.
In support of prior studies, use of non-steroidal anti-inflammatory drugs was associated with a statistically significant lower risk of polyp recurrence. "NSAID use reduces the risk of polyp recurrence by about 30 per cent; however, we know that these drugs are not recommended for use for polyp prevention because of side effects," the researchers note.
