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Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer

AIM: To determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS: Data was collected from medical records of 14663 subjects found to have...

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Autores principales: Mouchli, Mohamad A, Ouk, Lidia, Scheitel, Marianne R, Chaudhry, Alisha P, Felmlee-Devine, Donna, Grill, Diane E, Rashtak, Shahrooz, Wang, Panwen, Wang, Junwen, Chaudhry, Rajeev, Smyrk, Thomas C, Oberg, Ann L, Druliner, Brooke R, Boardman, Lisa A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829154/
https://www.ncbi.nlm.nih.gov/pubmed/29491684
http://dx.doi.org/10.3748/wjg.v24.i8.905
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author Mouchli, Mohamad A
Ouk, Lidia
Scheitel, Marianne R
Chaudhry, Alisha P
Felmlee-Devine, Donna
Grill, Diane E
Rashtak, Shahrooz
Wang, Panwen
Wang, Junwen
Chaudhry, Rajeev
Smyrk, Thomas C
Oberg, Ann L
Druliner, Brooke R
Boardman, Lisa A
author_facet Mouchli, Mohamad A
Ouk, Lidia
Scheitel, Marianne R
Chaudhry, Alisha P
Felmlee-Devine, Donna
Grill, Diane E
Rashtak, Shahrooz
Wang, Panwen
Wang, Junwen
Chaudhry, Rajeev
Smyrk, Thomas C
Oberg, Ann L
Druliner, Brooke R
Boardman, Lisa A
author_sort Mouchli, Mohamad A
collection PubMed
description AIM: To determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS: Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS: 84/4610 (1.8%) patients developed CRC at the polypectomy site within a median of 4.2 years (mean 4.89 years), and 1.2% (54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years (mean 6.67 years). Approximately, 30% (25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8% (15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC development at the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION: Recognition that CRC may develop following AA/TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality.
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spelling pubmed-58291542018-02-28 Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer Mouchli, Mohamad A Ouk, Lidia Scheitel, Marianne R Chaudhry, Alisha P Felmlee-Devine, Donna Grill, Diane E Rashtak, Shahrooz Wang, Panwen Wang, Junwen Chaudhry, Rajeev Smyrk, Thomas C Oberg, Ann L Druliner, Brooke R Boardman, Lisa A World J Gastroenterol Retrospective Cohort Study AIM: To determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS: Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS: 84/4610 (1.8%) patients developed CRC at the polypectomy site within a median of 4.2 years (mean 4.89 years), and 1.2% (54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years (mean 6.67 years). Approximately, 30% (25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8% (15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC development at the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION: Recognition that CRC may develop following AA/TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality. Baishideng Publishing Group Inc 2018-02-28 2018-02-28 /pmc/articles/PMC5829154/ /pubmed/29491684 http://dx.doi.org/10.3748/wjg.v24.i8.905 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Mouchli, Mohamad A
Ouk, Lidia
Scheitel, Marianne R
Chaudhry, Alisha P
Felmlee-Devine, Donna
Grill, Diane E
Rashtak, Shahrooz
Wang, Panwen
Wang, Junwen
Chaudhry, Rajeev
Smyrk, Thomas C
Oberg, Ann L
Druliner, Brooke R
Boardman, Lisa A
Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
title Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
title_full Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
title_fullStr Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
title_full_unstemmed Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
title_short Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
title_sort colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829154/
https://www.ncbi.nlm.nih.gov/pubmed/29491684
http://dx.doi.org/10.3748/wjg.v24.i8.905
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