Korean Guidelines for Postpolypectomy Colonoscopy Surveillance

Abstract

Postpolypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. In this report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy and we elucidated the high risk findings of the index colonoscopy as follows: 3 or more adenomas, any adenoma larger than 10 mm, any tubulovillous or villous adenoma, any adenoma with high-grade dysplasia, and any serrated polyps larger than 10 mm. Surveillance colonoscopy should be performed five years after the index colonoscopy for those without any high-risk findings and three years after the index colonoscopy for those with one or more high risk findings. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polypectomy, the patient's general condition, and family and medical history.

Colorectal cancer screening of the general population in East Asia

“…Many of the recommendations in these guidelines were made based on evidence from Western countries in which the environments differ from those in Korea. 14 Therefore, more studies of Korean populations should be carried out.…”

“…It is recommended that surveillance colonoscopy in Korea should be done 3 years after polypectomy in patients with high-risk findings, or 5 years after in patients without high-risk findings. 14 These guidelines have been established by evidence-based methods. However, the Korean literature on CRC screening, polyp detection, and post-polypectomy colonoscopy surveillance is limited.…”

Probability of High-Risk Colorectal Neoplasm Recurrence Based on the Results of Two Previous Colonoscopies

“…First, the interval between colonoscopies was not standardized and relatively short. Because many surveillance colonoscopies in this study were performed for self-referred participants who concerned about their health, visited our center voluntarily, and requested earlier surveillance, the surveillance interval was shorter than recommended by international and Korean guidelines [8,9,21]. Second, our analysis was based only on a part of a patient's lifetime.…”

The Serrated Polyp Pathway: Is It Time to Alter Surveillance Guidelines?

“…They recommended 3 year intervals for proximal SPs, SPs ≥ 10mm, or SPs with cytological dysplasia. Since that time, multiple expert panels and professional societies have published detailed guidelines with regards to the management of HPs, SSPs, and TSAs (Table 1) [34,62–64]. Of these, the recommendations of the US Multisociety Task Force and the International Consensus Panel are the two most frequently encountered in practice in North America.…”