title: Endoscopic surveillance in patients with multiple (10-100) colorectal polyps.
abstract: OBJECTIVE
  Endoscopic surveillance in patients with multiple colorectal polyps aims to reduce colorectal cancer (CRC) incidence and mortality, as well as the need for colorectal surgery. The aim of this study was to determine the risk of developing CRC or the need for surgery during endoscopic surveillance in a cohort of patients with multiple (10 - 100) colorectal polyps.
  
  
  METHODS
  This was a multicentrer, longitudinal, observational study in 15 CRC high risk clinics in Spain, carried out between January 2009 and December 2010. Patients who were included in the EPIPOLIP trial and had at least 1 year of follow-up were included in the study. The primary outcome of interest was the incidence of CRC at least 1 year following the initial colonoscopy. The secondary outcome was the need for colorectal surgery.
  
  
  RESULTS
  A total of 265 patients were followed for a median of 3.8 years. Patients underwent a median of 5 colonoscopies, and 17 patients (6.4 %) were diagnosed with CRC. A total of 32 patients (12.1 %) underwent surgery, including 15 (5.7 %) for prophylaxis without a diagnosis of CRC. The corresponding incidence density rates for CRC and colorectal surgery were 1.4 (95 % confidence interval [CI] 0.7 to 2.1) and 2.7 (95 %CI 1.7 to 3.6) per 100 patient-years, respectively. Only the presence of symptoms at first colonoscopy was independently associated with CRC diagnosis (hazard ratio [HR] 7.7, 95 %CI 1.1 to 59.3) and colorectal surgery (HR 4.6, 95 %CI 1.02 to 20.6).
  
  
  CONCLUSIONS
  Patients with more than 10 neoplastic polyps required frequent colonoscopies within a short follow-up period. More than 10 % of patients required colorectal surgery within 4 years, more than half for incident CRC.
authors.affiliation: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors.forename: Fátima
authors.initials: F
authors.lastname: Valentín
authors.affiliation: Unidad de Investigación, Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Carla
authors.initials: C
authors.lastname: Guarinos
authors.affiliation: Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Miriam
authors.initials: M
authors.lastname: Juárez
authors.affiliation: Unidad de Investigación, Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Rodríguez-Soler
authors.affiliation: Unitat d'Avaluació, Suport i Prevenció, Hospital Clínic, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Serradesanferm
authors.affiliation: Department of Gastroenterology, Bellvitge University Hospital, Hospitalet, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodriguez-Moranta
authors.affiliation: Department of Gastroenterology, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Nicolas-Perez
authors.affiliation: Department of Gastroenterology, Donostia Hospital/Biodonostia Institute, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University of Basque Country (UPV/EHU), San Sebastián, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Bujanda
authors.affiliation: Department of Gastroenterology, Clínica Universitaria de Navarra, Pamplona, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Herraiz
authors.affiliation: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
authors.forename: Luisa
authors.initials: L
authors.lastname: De-Castro
authors.affiliation: Department of Gastroenterology, Hospital Universitari Mutua de Terrassa, CIBERehd, Terrassa, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Bañares
authors.affiliation: Department of Gastroenterology, IDIPHIM, Hospital Universitario Puerta De Hierro, Majadahonda, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Herreros-de-Tejada
authors.affiliation: Department of Gastroenterology, Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Martínez
authors.affiliation: Department of Oncology, Hospital Arnau de Vilanova, Lleida, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Aguirre
authors.affiliation: Servicio de Aparato Digestivo, Hospital Clínico Universitario, IIS Aragón, University of Zaragoza, CIBERehd, Zaragoza, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Ferrández
authors.affiliation: Department of Gastroenterology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Díaz-Tasende
authors.affiliation: Department of Gastroenterology, Hospital Josep Trueta, Girona, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Piñol
authors.affiliation: Department of Pathology, Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Artemio
authors.initials: A
authors.lastname: Paya
authors.affiliation: Department of Pathology, Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Egoavil
authors.affiliation: Department of Pathology, Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Alenda
authors.affiliation: Department of Gastroenterology, Hospital Clínic, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Castells
authors.affiliation: Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jover
authors.affiliation: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Cubiella
mesh_terms: D018256:Adenomatous Polyps / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D015994:Incidence; D007417:Intestinal Polyps / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013030:Spain; D055815:Young Adult