Original articleClinical endoscopyOngoing colorectal cancer risk despite surveillance colonoscopy: the Polyp Prevention Trial Continued Follow-up Study
Section snippets
Study participants
The PPT enrolled 2079 patients who had a baseline enrollment colonoscopy (T0) with at least 1 adenomatous polyp but no history of CRC. Details of the study population have been reported.11 Subjects were randomized to a dietary intervention to adopt a diet low in fat and high in fiber, fruits, and vegetables instead of their usual diet. A repeat colonoscopy was performed in 1 to 2 years (T1) to detect and remove lesions that may have been missed at the baseline colonoscopy. Subjects underwent a
Results
Of 2079 patients enrolled in the PPT, 1905 completed the study. Of those who completed the PPT, 1297 (68%) agreed to participate in the PPT-CFS and were followed for a median of 6.2 years. PPT-CFS participants compared with PPT subjects who did not participate in the PPT-CFS were more likely to be male (67% vs 59%, P < .001), more educated (78% vs 68% post–high school education, P < .001), and to have a family history of CRC (28% vs 24%, P = .03) (Table 1). During the PPT, PPT-CFS participants
Discussion
CRC developed in 9 participants during the PPT-CFS, for a rate of 1.2 cases/1000 PYO, despite undergoing a mean of more than 3 colonoscopies during the PPT. This interval cancer rate was 64% of that expected by SEER, and when cancers detected in the main PPT and the CFS were combined, the overall rate was 74% of that expected by SEER. The absolute rates were not statistically significantly different from that expected based on SEER data. Our study included a relatively prolonged (>10 years)
Acknowledgment
We acknowledge Westat, Inc, for their work as the coordinating center for the PPT-CFS.
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 139.