Gastroenterology

Gastroenterology

Volume 143, Issue 3, September 2012, Pages 844-857
Gastroenterology

AGA
Guidelines for Colonoscopy Surveillance After Screening and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer

https://doi.org/10.1053/j.gastro.2012.06.001Get rights and content

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Literature Review

We performed a MEDLINE search of the postpolypectomy literature under the subject headings of colonoscopy, adenoma, polypectomy surveillance, and adenoma surveillance, limited to English language articles from 2005 to 2011. Subsequently, additional articles were gleaned from references of the reviewed articles. Relevant studies include those in which outcomes addressed the relationship between baseline examination findings and the detection of CRC, advanced adenoma, or any adenoma during the

New evidence documents the risk of developing interval CRC after polypectomy or negative findings on baseline colonoscopy

New data have emerged on the risk of interval cancer after colonoscopy. Data from studies in which patients had adenomas detected and removed were analyzed in a pooling project funded by the National Cancer Institute (NCI) (hereafter referred to as the NCI Pooling Project).7 These include randomized controlled trials to evaluate chemoprevention8, 9, 10, 11, 12, 13 and cohort studies.1, 14, 15 The overall rate of interval cancer was 1.1–2.7 per 1000 person-years of follow-up.

Interval cancers

Discussion

The 2006 MSTF guideline provided a valuable framework for polyp surveillance based on the histology and number of polyps detected at the baseline examination. We find that new data since 2006 support these recommendations.

The current guideline recommendations apply only to high-quality baseline examinations.

Quality indicators37, 38, 39 for reporting and performance have been well documented and should become part of routine endoscopic practice. Several key performance indicators, such as cecal

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    Conflicts of interest The authors disclose the following: D.A.L. is an advisory board member for Given Imaging and Exact Sciences. D.K.R. is an advisory board member for Given Imaging and has received research funding from Olympus Corp. D.A.J. is a clinical investigator for Exact Sciences and an advisory board member for Given Imaging. The remaining authors disclose no conflicts.

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