title: Adenoma characteristics at first colonoscopy as predictors of adenoma recurrence and characteristics at follow-up. The Polyp Prevention Study Group.
abstract: OBJECTIVE
  All patients with colorectal adenomas may not require identical follow-up. We aimed to determine if adenoma characteristics at initial colonoscopy could predict adenoma recurrence or characteristics at follow-up.
  
  
  METHODS
  The number of adenomas and the size, type, and degree of atypia in 479 patients in a polyp prevention trial were evaluated as predictors of the same characteristics at follow-up using odds ratios (ORs) with 95% confidence intervals (CIs). Multiple logistic regression analysis was performed to determine if several baseline characteristics were simultaneously associated with outcome.
  
  
  RESULTS
  Although several characteristics were significant predictors of recurrence univariately, by multivariate analysis, multiple adenomas at follow-up were more likely when patients had > or = 3 baseline adenomas (OR, 2.25; 95% CI, 1.20-4.21) or at least 1 tubulovillous adenoma (OR, 2.12; 95% CI, 1.12-4.02). No specific characteristic was associated with recurrence of high-risk polyps (> or = 1 cm, villous, severe atypia). Seventy percent of patients with 1 or 2 baseline adenomas had no recurrence, and only 3.3% had any adenomas of clinical concern.
  
  
  CONCLUSIONS
  Number and type of baseline adenomas predict recurrent adenomas, but the recurrence is rarely of clinical concern. Patients with 1 or 2 tubular adenomas constitute a low-risk group for whom follow-up might be extended beyond 3 years.
authors.affiliation: Department of Gastroenterology, Cleveland Clinic Foundation, Ohio, USA.
authors.forename: R U
authors.initials: RU
authors.lastname: van Stolk
authors.forename: G J
authors.initials: GJ
authors.lastname: Beck
authors.forename: J A
authors.initials: JA
authors.lastname: Baron
authors.forename: R
authors.initials: R
authors.lastname: Haile
authors.forename: R
authors.initials: R
authors.lastname: Summers
mesh_terms: D000236:Adenoma / Q000473:pathology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local