The presence of more than two index adenomas is the strongest predictor of metachronous colon adenomas.
OBJECTIVE
To assess whether patient or adenoma characteristics at index colonoscopy could be predictors of metachronous adenomas and of advanced metachronous adenomas at first surveillance colonoscopy.


METHODS
This retrospective study evaluated polypectomies of 372 adenomas in 214 patients who underwent a first follow-up colonoscopy after a median of 17 months. Logistic regression analysis was used to assess the association of baseline patient and adenoma characteristics with the development of any metachronous adenomas and of advanced adenomas (>1.0 cm, or villous component, or severe dysplasia, or early cancer).


RESULTS
Eighty-one patients (38%) demonstrated 130 metachronous adenomas including 21 cases (10%) with advanced adenomas. The presence of more than 2 baseline adenomas was significantly associated with the finding of adenomas at follow-up (odds ratio 2.44, 95% confidence interval 1.27-4.68, p = 0.010). Patient age (>or= 60 versus <60) and size of largest adenoma (>1.0 cm versus <or= 1.0 cm) demonstrated borderline significance. However, neither gender, most advanced histology (tubulo-villous/villous versus tubular), nor most advanced dysplasia (severe/early cancer versus mild/moderate) at baseline colonoscopy were related with the development of metachronous adenomas. Furthermore, none of the analysed patient and polyp characteristics demonstrated an association with the development of advanced metachronous adenomas.


CONCLUSIONS
Patients with over 2 adenomas at baseline colonoscopy are at highest risk for the finding of adenomas at follow-up.
Külling
Daniel
D
Department of Internal Medicine, University Hospital of Zurich, Switzerland. kulling@gmx.ch
Christ
Andreas D
AD
Karaaslan
Nidayi
N
Fried
Michael
M
Bauerfeind
Peter
P
D000236:Adenoma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D003113:Colonoscopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000473:pathology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology