title: Yield of second surveillance colonoscopy to predict adenomas with high-risk characteristics.
abstract: OBJECTIVE
  The yield of surveillance colonoscopies for patients with a history of polyps is well established for first surveillance, but limited for second surveillance. The aim of this study was to evaluate the proportion of high-risk adenomas at second surveillance colonoscopy based on findings of previous colonoscopies.
  
  
  METHODS
  This retrospective cohort study was conducted in a tertiary hospital and patients who had undergone three colonoscopies were included. Based on the findings at index colonoscopy, patients were categorized into three groups: high-risk adenoma (n=252), low-risk adenoma (n=158) or no-adenoma (n=318). Findings of subsequent high-risk adenoma, low-risk adenoma and no adenoma at surveillance colonoscopies were documented in each group.
  
  
  RESULTS
  Among patients with high-risk adenoma at index and first surveillance colonoscopies, significantly higher rates of high-risk findings were found at second surveillance, compared with patients who had low-risk or no-adenoma at index colonoscopy and high-risk adenoma at first surveillance colonoscopy (58%, 33% and 10%, respectively, p<0.001).
  
  
  CONCLUSIONS
  Both index colonoscopy and first surveillance high-risk adenoma have an impact on incidence high-risk findings at second surveillance colonoscopy and these subjects need close surveillance.
authors.affiliation: Gastroenterology and Hepatology Institute, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: ido.laish@gmail.com.
authors.forename: Ido
authors.initials: I
authors.lastname: Laish
authors.affiliation: Gastroenterology and Hepatology Institute, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Ido
authors.initials: I
authors.lastname: Blechman
authors.affiliation: Gastroenterology and Hepatology Institute, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Haya
authors.initials: H
authors.lastname: Feingelernt
authors.affiliation: Gastroenterology and Hepatology Institute, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Fred M
authors.initials: FM
authors.lastname: Konikoff
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers
keywords: Colon cancer; Colonoscopy intervals; High risk adenoma; Surveillance colonoscopy