title: Risk of advanced lesions at first follow-up colonoscopy in high-risk groups as defined by the United Kingdom post-polypectomy surveillance guideline: data from a single U.S. center.
abstract: BACKGROUND
  The United Kingdom (U.K.) post-adenoma resection guidelines recommend earlier surveillance for patients with 5 or more adenomas or 3 to 4 adenomas of which one is 10 mm or larger compared with U.S. guidelines.
  
  
  OBJECTIVE
  To evaluate the effect of using the U.K. guideline on a U.S. cohort of adenoma patients.
  
  
  METHODS
  Single-center, retrospective study.
  
  
  METHODS
  Indiana University Hospital and an associated ambulatory surgery center.
  
  
  METHODS
  A total of 1414 patients with baseline adenoma findings belonging to one of 5 risk categories and with a follow-up colonoscopy more than 200 days later.
  
  
  METHODS
  Colonoscopy, polypectomy.
  
  
  METHODS
  Incidence of advanced lesions at follow-up colonoscopy.
  
  
  RESULTS
  Advanced neoplasms at follow-up occurred in 16.3% of patients with 5 or more adenomas including 1 that was 10 mm or larger, 8.6% of patients with 3 or 4 adenomas including 1 that was 10 mm or larger, 5% of those with 5 or more adenomas all smaller than 10 mm, 1.8% of those with 3 or 4 adenomas all smaller than 10 mm, and 1.4% of those with 1 to 2 adenomas smaller than 10 mm. Logistic regression analyses showed that the rate of advanced lesions at first follow-up was increased in persons with 3 or more baseline adenomas and at least 1 that is 10 mm or larger compared with those with 1 to 4 small baseline adenomas.
  
  
  CONCLUSIONS
  Single-center, retrospective study.
  
  
  CONCLUSIONS
  Our results indicate the U.K. guideline predicts higher risk groups for advanced neoplasia at first follow-up. Our study had inadequate power to show better prediction of incident cancer. Additional study of other databases is warranted.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Vemulapalli
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Rex
mesh_terms: D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D003111:Colonic Polyps / Q000473:pathology* / Q000601:surgery; D003113:Colonoscopy / Q000592:standards*; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D047368:Tumor Burden; D006113:United Kingdom; D014481:United States / Q000453:epidemiology