Follow-up after polypectomy: consensus?
Patients who have had a colorectal adenoma resected have an increased risk of subsequent cancer and may benefit from follow-up surveillance. Surveillance strategies should be tailored to the assessed risk of each individual patient. A number of long-term follow-up studies indicate that the risk of metachronous neoplasia is higher if on index colonoscopy there were multiple (> or = 2) adenomas, or if any adenoma was large (> or = 1 cm), contained villous tissue or severe dysplasia, or if the patient had a family history of colorectal neoplasia. Data from the U.S. National Polyp Study indicate that polyp resection and follow-up surveillance greatly reduces the incidence of metachronous cancer, and that the first follow-up colonoscopy does not need to be performed for 3 years. Current data have been incorporated into a comprehensive consensus practice guideline.
Bond
J H
JH
Gastroenterology Section (111D), VA Medical Center, Minneapolis, Minnesota 55417, USA.
D000236:Adenoma / Q000601:surgery*; D002985:Clinical Protocols; D003113:Colonoscopy / Q000191:economics; D015179:Colorectal Neoplasms / Q000517:prevention & control / Q000601:surgery*; D003362:Cost-Benefit Analysis; D006801:Humans; D007417:Intestinal Polyps / Q000601:surgery*; D008134:Long-Term Care / Q000379:methods