Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer

Mohamad A. Mouchli, Lidia Ouk, Marianne R. Scheitel, Alisha P. Chaudhry, Donna Felmlee-Devine, Diane E. Grill, Shahrooz Rashtak, Panwen Wang, Junwen Wang, Rajeev Chaudhry, Thomas Christopher Smyrk, Ann L Oberg, Brooke R. Druliner, Lisa Allyn Boardman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

AIM to determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS 84/4610 (1.8%) patients developed CRC at the polypectomy site within a median of 4.2 years (mean 4.89 years), and 1.2% (54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years (mean 6.67 years). Approximately, 30% (25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8% (15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC development at the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION Recognition that CRC may develop following AA/ TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality..

Original languageEnglish (US)
Pages (from-to)905-916
Number of pages12
JournalWorld Journal of Gastroenterology
Volume24
Issue number8
DOIs
StatePublished - Feb 28 2018

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Colonoscopy
Polyps
Adenoma
Colorectal Neoplasms
Risk Management
Genetic Predisposition to Disease
Inflammatory Bowel Diseases

Keywords

  • Advanced adenoma
  • Colon cancer
  • High risk polyps
  • Post-polypectomy colorectal cancer
  • Rectal Cancer
  • Sessile serrated adenoma

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Mouchli, M. A., Ouk, L., Scheitel, M. R., Chaudhry, A. P., Felmlee-Devine, D., Grill, D. E., ... Boardman, L. A. (2018). Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer. World Journal of Gastroenterology, 24(8), 905-916. https://doi.org/10.3748/wjg.v24.i8.905

Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer. / Mouchli, Mohamad A.; Ouk, Lidia; Scheitel, Marianne R.; Chaudhry, Alisha P.; Felmlee-Devine, Donna; Grill, Diane E.; Rashtak, Shahrooz; Wang, Panwen; Wang, Junwen; Chaudhry, Rajeev; Smyrk, Thomas Christopher; Oberg, Ann L; Druliner, Brooke R.; Boardman, Lisa Allyn.

In: World Journal of Gastroenterology, Vol. 24, No. 8, 28.02.2018, p. 905-916.

Research output: Contribution to journalArticle

Mouchli, MA, Ouk, L, Scheitel, MR, Chaudhry, AP, Felmlee-Devine, D, Grill, DE, Rashtak, S, Wang, P, Wang, J, Chaudhry, R, Smyrk, TC, Oberg, AL, Druliner, BR & Boardman, LA 2018, 'Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer', World Journal of Gastroenterology, vol. 24, no. 8, pp. 905-916. https://doi.org/10.3748/wjg.v24.i8.905
Mouchli MA, Ouk L, Scheitel MR, Chaudhry AP, Felmlee-Devine D, Grill DE et al. Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer. World Journal of Gastroenterology. 2018 Feb 28;24(8):905-916. https://doi.org/10.3748/wjg.v24.i8.905
Mouchli, Mohamad A. ; Ouk, Lidia ; Scheitel, Marianne R. ; Chaudhry, Alisha P. ; Felmlee-Devine, Donna ; Grill, Diane E. ; Rashtak, Shahrooz ; Wang, Panwen ; Wang, Junwen ; Chaudhry, Rajeev ; Smyrk, Thomas Christopher ; Oberg, Ann L ; Druliner, Brooke R. ; Boardman, Lisa Allyn. / Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer. In: World Journal of Gastroenterology. 2018 ; Vol. 24, No. 8. pp. 905-916.
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abstract = "AIM to determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS 84/4610 (1.8{\%}) patients developed CRC at the polypectomy site within a median of 4.2 years (mean 4.89 years), and 1.2{\%} (54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years (mean 6.67 years). Approximately, 30{\%} (25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8{\%} (15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC development at the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION Recognition that CRC may develop following AA/ TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality..",
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AU - Ouk, Lidia

AU - Scheitel, Marianne R.

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AU - Felmlee-Devine, Donna

AU - Grill, Diane E.

AU - Rashtak, Shahrooz

AU - Wang, Panwen

AU - Wang, Junwen

AU - Chaudhry, Rajeev

AU - Smyrk, Thomas Christopher

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AU - Druliner, Brooke R.

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N2 - AIM to determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS 84/4610 (1.8%) patients developed CRC at the polypectomy site within a median of 4.2 years (mean 4.89 years), and 1.2% (54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years (mean 6.67 years). Approximately, 30% (25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8% (15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC development at the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION Recognition that CRC may develop following AA/ TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality..

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