Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies

Risk stratification by index colonoscopy is well established for first surveillance endoscopy, but whether the previous two colonoscopies affect the subsequent advanced neoplasias has not been established. Therefore, the subsequent risk based on the findings of the index and first surveillance colon...

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Bibliographic Details
Published in:PloS one 2021-01, Vol.16 (1), p.e0245211-e0245211
Main Authors: Honda, Munenori, Naoe, Hideaki, Gushima, Ryosuke, Miyamoto, Hideaki, Tateyama, Masakuni, Sakurai, Kouichi, Oda, Yasushi, Murakami, Yoshitaka, Tanaka, Yasuhito
Format: Article
Language:English
Subjects:
Adenoma - diagnostic imaging
Adenoma - epidemiology
Age
Aged
Cancer
Care and treatment
Clinics
Colonoscopy
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - epidemiology
Diagnosis
Early Detection of Cancer
Editing
Endoscopes
Endoscopy
Evaluation
Female
Gastroenterology
Guidelines
Health risk assessment
Health risks
Hepatology
Histology
Humans
Incidence
Indexing
Inflammatory bowel disease
Male
Medicine and Health Sciences
Middle Aged
Morbidity
Observations
Patients
Polyethylene glycol
Polyps
Proportional Hazards Models
Retrospective Studies
Reviews
Risk Assessment
Statistical analysis
Surveillance
Tumors
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Summary:Risk stratification by index colonoscopy is well established for first surveillance endoscopy, but whether the previous two colonoscopies affect the subsequent advanced neoplasias has not been established. Therefore, the subsequent risk based on the findings of the index and first surveillance colonoscopies were investigated. This retrospective, cohort study was conducted in two clinics and included participants who had undergone two or more colonoscopies after index colonoscopy. High-risk was defined as advanced adenoma (≥ 1 cm, or tubulovillous or villous histology, or high-grade dysplasia). Based on the findings of the index and first surveillance colonoscopies, patients were classified into four categories: category A (both colonoscopy findings were normal), category B (no high-risk findings both times), category C (one time high-risk finding), and category D (high-risk findings both times). The incidence of subsequent advanced neoplasia was examined in each category. A total of 13,426 subjects were included and surveyed during the study periods. The subjects in category D had the highest risk of advanced neoplasia (27.4%, n = 32/117). The subjects in category A had the lowest risk (4.0%, n = 225/5,583). The hazard ratio for advanced neoplasia of category D compared to category A was 9.90 (95% Confidence interval 6.82-14.35, P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0245211