High-Risk Adenomas at Screening Colonoscopy Remain Predictive of Future High-Risk Adenomas Despite an Intervening Negative Colonoscopy

Brian A. Sullivan, Thomas S. Redding, Elizabeth R. Hauser, Ziad F. Gellad, Xuejun Qin, Samir Gupta, Douglas J. Robertson, David G. Weiss, Meghan C. OʼLeary, Ashton N. Madison, Kellie J. Sims, Christina D. Williams, Julian C. Hong, David Lieberman, Dawn Provenzale

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Limited data inform the current postpolypectomy surveillance guidelines, which suggest a shortened interval to third colonoscopy after a negative second examination if high-risk adenomas (HRA) were present on the initial screening colonoscopy. Therefore, we examined the risk of HRA at third colonoscopy stratified by findings on 2 previous examinations in a prospective screening colonoscopy cohort of US veterans. METHODS: We identified participants who had 3 or more colonoscopies from CSP#380. We examined the risk of HRA on the third examination based on findings from the previous 2 examinations. Multivariate logistic regression was used to adjust for multiple covariates. RESULTS: HRA were found at the third examination in 114 (12.8%) of 891 participants. Those with HRA on both previous examinations had the greatest incidence of HRA at third examination (14/56, 25.0%). Compared with those with no adenomas on both previous examinations, participants with HRA on the first examination remained at significantly increased risk for HRA at the third examination at 3 years after a negative second examination (odds ratio [OR] 3.41, 95% confidence interval [CI] 1.28-9.08), 5 years (OR 3.14, 95% CI 1.49-6.61), and 7 years (OR 2.89, 95% CI 1.08-7.74). DISCUSSION: In a screening population, HRA on the first examination identified individuals who remained at increased risk for HRA at the third examination, even after a negative second examination. This finding supports current colorectal cancer surveillance guidelines, which suggest a shortened, 5-year time interval to third colonoscopy after a negative second examination if high-risk findings were present on the baseline examination.

Original languageEnglish (US)
Pages (from-to)1275-1282
Number of pages8
JournalThe American journal of gastroenterology
Volume115
Issue number8
DOIs
StatePublished - Aug 1 2020

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Sullivan, B. A., Redding, T. S., Hauser, E. R., Gellad, Z. F., Qin, X., Gupta, S., Robertson, D. J., Weiss, D. G., OʼLeary, M. C., Madison, A. N., Sims, K. J., Williams, C. D., Hong, J. C., Lieberman, D., & Provenzale, D. (2020). High-Risk Adenomas at Screening Colonoscopy Remain Predictive of Future High-Risk Adenomas Despite an Intervening Negative Colonoscopy. The American journal of gastroenterology, 115(8), 1275-1282. https://doi.org/10.14309/ajg.0000000000000677