Long-term risk of colorectal cancer after adenoma removal: a population-based cohort study

Abstract

In routine practice, the risk of colorectal cancer after adenoma removal remains high and depends both on initial adenoma features and on colonoscopy surveillance practices. Gastroenterologists should encourage patients to comply with long-term colonoscopic surveillance.

A Direct Comparison of the Prevalence of Advanced Adenoma and Cancer between Surveillance and Screening Colonoscopies

“…This might indicate a protective effect of clearing the colon of adenomas during a prior colonoscopy. Our frequencies of findings are in line with other studies, for example Cottet et al [14] reported on 4,881 colonoscopies done for surveillance after removal of adenoma: 29.6% colonoscopies revealed a non-advanced adenoma, 10.1% an advanced adenoma, and 0.1% cancer as the most advanced lesion found. The researchers of the National Polyp Study reported on 26.6% non-advanced adenomas upon the first surveillance colonoscopy and 20.7% non-advanced adenomas upon the second surveillance colonoscopy [19].…”

“…The high adenoma detection rate in the post-adenoma surveillance group is mainly due to the high number of non-advanced adenomas resulting in a non-advanced-to-advanced adenoma ratio of 3.5 compared to a ratio of 2.4 in the screening group. An even higher adenoma detection rate of 39.7% and a similarly high ratio of 2.9 have previously been reported in a cohort of post-adenoma surveillance colonoscopies [14]. …”

“…It has been demonstrated that the frequency of metachronous cancer detected upon surveillance colonoscopy after resection of colorectal cancer is comparable with the rate of cancers detected upon screening colonoscopy [8]. Studies on the risk of metachronous cancer after polypectomy have yielded discordant results: some studies have reported an increased risk [10,11,12,13,14], others have reported a reduced risk [6,15,16,17]. …”

S3-Leitlinie – Kolorektales Karzinom

“…Das Risiko hängt entscheidend von der Anzahl, der Größe und Histologie der entfernten Adenome ab [619]. Patienten mit 1 oder 2 kleinen tubulären Adenomen haben kein wesentlich erhöhtes Karzinomrisiko [210,609,610]. Eine Kontrollkoloskopie nach 5 bis 10 Jahren erscheint daher ausreichend zu sein.…”

Demographic And Histopathological Characteristics Of Colorectal Polyps: A Descriptive Study Based On Samples Obtained From Symptomatic Patients

“…The epithelial type (either adenomatous or hyperplastic) represents the most common form of colorectal polyps, followed by non-epithelial (inflammatory and juvenile) polyps (5). Some polyp types, especially adenomas, are considered to be precursors of CRC (6,7). Despite the evidence on the beneficial role of screening in reducing the burden of CRC (8), in Albania no screening programs or prevention measures have been implemented due to limited financial and human resources.…”