Abstract
Background
After normal colonoscopy, the 5-year risk of colorectal neoplasia is sufficiently low for asymptomatic people over 50 years of age. In China, the incidence of colorectal carcinoma of Mongolian people is higher than that of Han people. The aim of this study was to assess the 5-year risk of colorectal neoplasia after normal colonoscopy in asymptomatic Chinese Mongolian population.
Patients and methods
A cohort of asymptomatic Chinese Mongolian people (≥50 years old) were recruited and followed up with colonoscopy 5 years after colonoscopy. Baseline colonoscopy and follow-up colonoscopy findings were categorized based on the most advanced lesions: no adenoma, nonadvanced adenoma, and advanced adenoma. Five-year risk of colorectal neoplasia in these people was assessed according to the rates of no baseline adenoma and advanced adenoma at the end of 5 years.
Results
A total of 480 of the 538 recruited people underwent follow-up colonoscopy at the end of 5 years. In people with no baseline adenoma, 27.3 % (82/301) was found to have any adenoma, and 1.7 % had advanced adenoma at follow-up colonoscopy. The risk of an advanced adenoma did not differ significantly between people with no adenoma at baseline and those with nonadvanced adenoma (relative risk (RR), 1.06; 95 % confidence interval (CI), 0.19–6.07). Advanced adenoma at baseline colonoscopy was the independent risk factor for advanced adenoma recurrence, compared with no adenoma at baseline (RR, 8.25; 95 % CI, 1.90–35.77).
Conclusion
The risk of advanced adenoma is low 5 years after the normal baseline colonoscopy, even in asymptomatic Chinese Mongolian population over 50 years of age.
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References
Winawer SJ, Zauber AG, Ho MN et al (1993) Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 329:1977–1981
Newcomb PA, Storer BE, Morimoto LM et al (2003) Long-term efficacy of sigmoidoscopy in the reduction of colorectal cancer incidence. J Natl Cancer Inst 95:622–625
Muller AD, Sonnenberg A (1995) Prevention of colorectal cancer by flexible endoscopy and polypectomy. A case–control study of 32,702 veterans. Ann Intern Med 123:904–910
Farrar WD, Sawhney MS, Nelson DB et al (2006) Colorectal cancers found after a complete colonoscopy. Clin Gastroenterol Hepatol 4:1259–1264
Lieberman DA, Weiss DG, Harford WV et al (2007) Five-year colon surveillance after screening colonoscopy. Gastroenterology 133:1077–1085
Moss SM, Hardcastle JD, Coleman DA et al (1999) Interval cancers in a randomized controlled trial of screening for colorectal cancer using a faecal occult blood test. Int J Epidemiol 28:386–390
Pabby A, Schoen RE, Weissfeld JL et al (2005) Analysis of colorectal cancer occurrence during surveillance colonoscopy in the dietary Polyp Prevention Trial. Gastrointest Endosc 61:385–391
Robertson DJ, Greenberg ER, Beach M et al (2005) Colorectal cancer in patients under close colonoscopic surveillance. Gastroenterology 129:34–41
Leung K, Pinsky P, Laiyemo AO et al (2009) Ongoing colorectal cancer risk despite surveillance colonoscopy: the Polyp Prevention Trial Continued Follow-up Study. Gastrointest Endosc 71:111–117
Winawer SJ, Zauber AG, Fletcher RH et al (2006) Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. CA Cancer J Clin 56:143–159, quiz 184-145
Brenner H, Chang-Claude J, Seiler CM et al (2007) Case-control study supports extension of surveillance interval after colonoscopic polypectomy to at least 5 yr. Am J Gastroenterol 102:1739–1744
Laiyemo AO, Murphy G, Albert PS et al (2008) Postpolypectomy colonoscopy surveillance guidelines: predictive accuracy for advanced adenoma at 4 years. Ann Intern Med 148:419–426
Atkin WS, Morson BC, Cuzick J (1992) Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med 326:658–662
van Stolk RU, Beck GJ, Baron JA et al (1998) Adenoma characteristics at first colonoscopy as predictors of adenoma recurrence and characteristics at follow-up. The Polyp Prevention Study Group. Gastroenterology 115:13–18
Noshirwani KC, van Stolk RU, Rybicki LA et al (2000) Adenoma size and number are predictive of adenoma recurrence: implications for surveillance colonoscopy. Gastrointest Endosc 51:433–437
Imperiale TF, Glowinski EA, Lin-Cooper C et al (2008) Five-year risk of colorectal neoplasia after negative screening colonoscopy. N Engl J Med 359:1218–1224
Leung WK, Lau JY, Suen BY et al (2009) Repeat-screening colonoscopy 5 years after normal baseline-screening colonoscopy in average-risk Chinese: a prospective study. Am J Gastroenterol 104:2028–2034
Winawer SJ, Zauber AG (2001) Colonoscopic polypectomy and the incidence of colorectal cancer. Gut 48:753–754
Brenner H, Chang-Claude J, Seiler CM et al (2006) Does a negative screening colonoscopy ever need to be repeated? Gut 55:1145–1150
Singh H, Turner D, Xue L et al (2006) Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies. JAMA 295:2366–2373
Schatzkin A, Lanza E, Corle D et al (2000) Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. Polyp Prevention Trial Study Group. N Engl J Med 342:1149–1155
Sansbury LB, Wanke K, Albert PS et al (2009) The effect of strict adherence to a high-fiber, high-fruit-and-vegetable, and low-fat eating pattern on adenoma recurrence. Am J Epidemiol 170:576–584
Regula J, Rupinski M, Kraszewska E et al (2006) Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med 355:1863–1872
Martinez ME, Baron JA, Lieberman DA et al (2009) A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology 136:832–841
Pinsky PF, Schoen RE, Weissfeld JL et al (2009) The yield of surveillance colonoscopy by adenoma history and time to examination. Clin Gastroenterol Hepatol 7:86–92
Fossi S, Bazzoli F, Ricciardiello L et al (2001) Incidence and recurrence rates of colorectal adenomas in first-degree asymptomatic relatives of patients with colon cancer. Am J Gastroenterol 96:1601–1604
Reid ME, Marshall JR, Roe D et al (2003) Smoking exposure as a risk factor for prevalent and recurrent colorectal adenomas. Cancer Epidemiol Biomarkers Prev 12:1006–1011
Wallace K, Baron JA, Karagas MR et al (2005) The association of physical activity and body mass index with the risk of large bowel polyps. Cancer Epidemiol Biomarkers Prev 14:2082–2086
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Huang, Y., Li, X., Wang, Z. et al. Five-year risk of colorectal neoplasia after normal baseline colonoscopy in asymptomatic Chinese Mongolian over 50 years of age. Int J Colorectal Dis 27, 1651–1656 (2012). https://doi.org/10.1007/s00384-012-1516-5
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DOI: https://doi.org/10.1007/s00384-012-1516-5