J Korean Med Sci.  2019 Apr;34(12):e101. 10.3346/jkms.2019.34.e101.

Appropriate Surveillance Interval after Colonoscopic Polypectomy in Patients Younger than 50 Years

• Jung YS
• Kim NH
• Park JH
• Park DI
• Sohn CI

• KMID: 2442100
• DOI: http://doi.org/10.3346/jkms.2019.34.e101

Abstract

BACKGROUND
Current postpolypectomy surveillance guidelines are based on studies in patients aged ≥50 years. Equal application of the guidelines in patients aged < 50 years may be unreasonable. We aimed to determine an appropriate surveillance interval after adenoma removal in patients aged < 50 years.
METHODS
We studied 10,013 patients who underwent ≥ 1 adenoma removal and follow-up colonoscopy. The cumulative risk of metachronous advanced colorectal neoplasia (ACRN) was compared among the eight groups based on age (30-39, 40-44, 45-49 and ≥ 50 years) and baseline adenoma characteristics (low- [LRA] and high-risk adenoma [HRA]).
RESULTS
The risk of metachronous ACRN in patients aged 30-39 and 40-44 years with HRA was comparable to that in those aged ≥ 50 years with LRA (P = 0.839 and P = 0.381, respectively). However, the risk in those aged 45-49 years with HRA was higher than in those aged ≥ 50 years with LRA (P = 0.003), and the risk was not significantly different from that in those aged ≥ 50 years with HRA (P = 0.092). Additionally, the 5-year cumulative risk in those aged 45-49 years with LRA was not significantly different from that in those aged ≥ 50 years with LRA.
CONCLUSION
The postpolypectomy surveillance interval can be extended up to 5 years in patients aged 30-44 years with HRA, similar to those aged ≥ 50 years with LRA. However, the interval in patients aged 45-49 years with HRA and LRA should be 3 and 5 years, respectively, similar to those aged ≥ 50 years.

Keyword

Metachronous Advanced Colorectal Neoplasia; Surveillance Colonoscopy Interval; Young

MeSH Terms

Adenoma
Colonoscopy
Follow-Up Studies
Humans