Five-Year Colon Surveillance After Screening Colonoscopy

David A. Lieberman, David G. Weiss, William V. Harford, Dennis J. Ahnen, Dawn Provenzale, Stephen J. Sontag, Thomas G. Schnell, Gregorio Chejfec, Donald R. Campbell, Jayashri Kidao, John H. Bond, Douglas B. Nelson, George Triadafilopoulos, Francisco C. Ramirez, Judith F. Collins, Tiina K. Johnston, Kenneth R. McQuaid, Harinder Garewal, Richard E. Sampliner, Romeo EsquivelDouglas Robertson

Research output: Contribution to journalArticle

325 Scopus citations

Abstract

Background & Aims: Outcomes of colon surveillance after colorectal cancer screening with colonoscopy are uncertain. We conducted a prospective study to measure incidence of advanced neoplasia in patients within 5.5 years of screening colonoscopy. Methods: Three thousand one hundred twenty-one asymptomatic subjects, age 50 to 75 years, had screening colonoscopy between 1994 and 1997 in the Department of Veterans Affairs. One thousand one hundred seventy-one subjects with neoplasia and 501 neoplasia-free controls were assigned to colonoscopic surveillance over 5 years. Cohorts were defined by baseline findings. Relative risks for advanced neoplasia within 5.5 years were calculated. Advanced neoplasia was defined as tubular adenoma greater than ≥10 mm, adenoma with villous histology, adenoma with high-grade dysplasia, or invasive cancer. Results: Eight hundred ninety-five (76.4%) patients with neoplasia and 298 subjects (59.5%) without neoplasia at baseline had colonoscopy within 5.5 years; 2.4% of patients with no neoplasia had interval advanced neoplasia. The relative risk in patients with baseline neoplasia was 1.92 (95% CI: 0.83-4.42) with 1 or 2 tubular adenomas <10 mm, 5.01 (95% CI: 2.10-11.96) with 3 or more tubular adenomas <10 mm, 6.40 (95% CI: 2.74-14.94) with tubular adenoma ≥10 mm, 6.05 (95% CI: 2.48-14.71) for villous adenoma, and 6.87 (95% CI: 2.61-18.07) for adenoma with high-grade dysplasia. Conclusions: There is a strong association between results of baseline screening colonoscopy and rate of serious incident lesions during 5.5 years of surveillance. Patients with 1 or 2 tubular adenomas less than 10 mm represent a low-risk group compared with other patients with colon neoplasia.

Original languageEnglish (US)
Pages (from-to)1077-1085
Number of pages9
JournalGastroenterology
Volume133
Issue number4
DOIs
StatePublished - Oct 2007

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Lieberman, D. A., Weiss, D. G., Harford, W. V., Ahnen, D. J., Provenzale, D., Sontag, S. J., Schnell, T. G., Chejfec, G., Campbell, D. R., Kidao, J., Bond, J. H., Nelson, D. B., Triadafilopoulos, G., Ramirez, F. C., Collins, J. F., Johnston, T. K., McQuaid, K. R., Garewal, H., Sampliner, R. E., ... Robertson, D. (2007). Five-Year Colon Surveillance After Screening Colonoscopy. Gastroenterology, 133(4), 1077-1085. https://doi.org/10.1053/j.gastro.2007.07.006