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KMID : 0191120190340120101
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Journal of Korean Medical Science
2019 Volume.34 No. 12 p.101 ~ p.101
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Appropriate Surveillance Interval after Colonoscopic Polypectomy in Patients Younger than 50 Years
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Jung Yoon-Suk
Kim Nam-Hee
Park Jung-Ho
Park Dong-Il
Sohn Chong-Il
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Abstract
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Background: Current postpolypectomy surveillance guidelines are based on studies in patients aged ≥50 years. Equal application of the guidelines in patients aged < 50 years may be unreasonable. We aimed to determine an appropriate surveillance interval after adenoma removal in patients aged < 50 years.
Methods: We studied 10,013 patients who underwent ≥ 1 adenoma removal and follow-up colonoscopy. The cumulative risk of metachronous advanced colorectal neoplasia (ACRN) was compared among the eight groups based on age (30?39, 40?44, 45?49 and ≥ 50 years) and baseline adenoma characteristics (low- [LRA] and high-risk adenoma [HRA]).
Results: The risk of metachronous ACRN in patients aged 30?39 and 40?44 years with HRA was comparable to that in those aged ≥ 50 years with LRA (P = 0.839 and P = 0.381, respectively). However, the risk in those aged 45?49 years with HRA was higher than in those aged ≥ 50 years with LRA (P = 0.003), and the risk was not significantly different from that in those aged ≥ 50 years with HRA (P = 0.092). Additionally, the 5-year cumulative risk in those aged 45?49 years with LRA was not significantly different from that in those aged ≥ 50 years with LRA.
Conclusion: The postpolypectomy surveillance interval can be extended up to 5 years in patients aged 30?44 years with HRA, similar to those aged ≥ 50 years with LRA. However, the interval in patients aged 45?49 years with HRA and LRA should be 3 and 5 years, respectively, similar to those aged ≥ 50 years.
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KEYWORD
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Metachronous Advanced Colorectal Neoplasia, Surveillance Colonoscopy Interval, Young
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