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Colonoscopy associated with recurrent colorectal neoplasia

A study in this month's Gastroenterology examines features of adenoma and colonoscopy associated with Recurrent Colorectal Neoplasia Based on a Large Community-Based Study

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Dr Else–Mariëtte van Heijningen and colleagues from the Netherlands  investigated adenoma and colonoscopy characteristics that are associated with recurrent colorectal neoplasia based on data from community-based surveillance practice.

The research team analyzed data of 2990 consecutive patients newly diagnosed with adenomas from 1988 to 2002 at 10 hospitals throughout The Netherlands.

Medical records were reviewed until 2008.

The team reported that they excluded patients with hereditary colorectal cancer syndromes, a history of colorectal cancer, inflammatory bowel disease, or without surveillance data.

The research team analyzed associations among adenoma number, size, grade of dysplasia, villous histology, and location with recurrence of advanced adenoma and nonadvanced adenoma.

Adenoma number had the greatest association with nonadvanced adenoma
Gastroenterology

The researchers performed a multivariable multinomial logistic regression analysis to estimate odds ratios and 95% confidence intervals.

During the surveillance period, 203 patients were diagnosed with advanced adenoma and 954 patients with nonadvanced adenoma.

The remaining 1833 patients had no adenomas during a median follow-up of 48 months.

The doctors found that factors associated with advanced adenoma during the surveillance period included baseline number of adenomas, adenoma size 10 mm, villous histology, proximal location, insufficient bowel preparation, and only distal colonoscopy reach.

Adenoma number had the greatest association with nonadvanced adenoma.

The team observed that high-grade dysplasia was not associated with advanced adenoma or nonadvanced adenoma.

Dr van Heijningen's team concludes, "Large size and number, villous histology, proximal location of adenomas, insufficient bowel preparation, and poor colonoscopy reach were associated with detection of advanced adenoma during surveillance based on data from community-based practice."

"These characteristics should be used jointly to develop surveillance policies for adenoma patients."

Gastroenterol 2013:144(7): 1410-1418
03 July 2013

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