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Incident Rates of Colonic Neoplasia According to Age and Gender: Implications for Surveillance Colonoscopy Intervals

Harewood, Gavin C MD, MSc*; Lawlor, Garrett O MB

Journal of Clinical Gastroenterology: November-December 2005 - Volume 39 - Issue 10 - p 894-899
doi: 10.1097/01.mcg.0000180630.54195.57
Alimentary Tract: Clinical Research
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Introduction: Current guidelines endorse surveillance colonoscopy at 3 to 5 years following initial detection of neoplasia. However, individual patients' risks may vary according to age and gender. This study aimed to characterize neoplasia recurrence in a large patient cohort undergoing surveillance colonoscopy.

Methods: All patients undergoing two colonoscopies at least 12 months apart between 1996 and 2000, with detection and removal of a polyp on the index colonoscopy, were identified using our endoscopic database to determine the incidence of colonic neoplasia. Patients were classified according to age (<50, 50-64, 65-74, ≥75 years) and gender.

Results: Overall, 1803 patients underwent two colonoscopies at least 12 months apart (median interval, 140 weeks) with removal of a polyp on initial examination. Polyps ≥5 mm were detected in 334 (19%) patients and polyps ≥10 mm in 105 (6%) on subsequent endoscopy. All age and gender groups were well matched with respect to size of polyp detected on initial colonoscopy (P = 0.2). Kaplan-Meier curves and a Cox proportional hazards model demonstrated similar rates of neoplasia recurrence for all patients irrespective of age and gender.

Conclusions: Similar rates of neoplasia recurrence were observed among patients of different gender and age groups on surveillance colonoscopy. From a health resource utilization perspective, these findings support current recommendations for similar surveillance intervals for patients regardless of age and gender.

From the *Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN; and †Mater Misericordiae Hospital, Dublin, Ireland.

Received for publication January 18, 2005; accepted March 29, 2005.

Reprints: Gavin C. Harewood, MD, MSc, Division of Gastroenterology and Hepatology, Gonda 9, Mayo Clinic, Rochester, MN 55905 (e-mail: harewood.gavin@mayo.edu).

© 2005 Lippincott Williams & Wilkins, Inc.