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Findings on Serial Surveillance Colonoscopy in Patients With Low-risk Polyps on Initial Colonoscopy

Miller, Jocelyne MD, MSCE*; Mehta, Neil MD; Feldman, Michael MD; Furth, Emma MD; Ginsberg, Gregory G. MD*; Yang, Yu-Xiao MD, MSCE*; Lewis, James D. MD, MSCE*

Journal of Clinical Gastroenterology: March 2010 - Volume 44 - Issue 3 - p e46-e50
doi: 10.1097/MCG.0b013e3181a7ed2a
ONLINE ARTICLES: Original Articles

Goals This study describes the prevalence of adenomatous polyps at serial follow-up exams after a colonoscopy finding 1 to 2 small tubular adenomas.

Study We conducted a retrospective cohort of patients with 1 to 2 small tubular adenomas on an initial colonoscopy who underwent at least 2 additional surveillance examinations. Our primary outcome was any or advanced adenomas on the third colonoscopy.

Results Eighty-eight patients met inclusion criteria. At the second and third colonoscopy, 31/88 (35.2%) patients and 26/88 (29.6%) patients had at least 1 adenoma, respectively. Among the 28 patients with 1 to 2 small tubular adenomas on colonoscopy no. 2, the prevalence of any adenomas on colonoscopy no. 3 was 39.3% [95% confidence interval (CI): 21.5%-59.4%]. Among the 56 patients without adenomas at colonoscopy no. 2, the prevalence of any and advanced adenomas on colonoscopy no. 3 was 25% (95% CI: 14.4%-38.4%), and 3.6% (95% CI: 0.4%-12.3%), respectively.

Conclusions In patients with 1-2 small tubular adenomas on initial colonoscopy the prevalence of adenomas and advanced lesions on the third colonoscopy remains high even if no adenomas are found on the second colonoscopy.

*Division of Gastroenterology, Department of Medicine

Department of Medicine

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA

Declaration of Funding Source: Supported by NIH grants T32DK007740 and K24-DK078228.

Reprints: Neil Mehta, MD, Department of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 100 Centrex, Philadelphia, PA (e-mail: nmehta14@hotmail.com).

Received for publication January 6, 2009; accepted March 30, 2009

Conflict of Interest Statement: No potential conflicts of interest that any of the authors have identified relevant to this article.

© 2010 Lippincott Williams & Wilkins, Inc.