Endoscopy 2020; 52(S 01): S120-S121
DOI: 10.1055/s-0040-1704371
ESGE Days 2020 oral presentations
Saturday, April 25, 2020 11:00 – 13:00 Finders keepers Liffey Hall 1
© Georg Thieme Verlag KG Stuttgart · New York

DIAGNOSTIC YIELD OF CLEARING COLONOSCOPY ONE-YEAR AFTER BASELINE COLONOSCOPY IN PATIENTS WITH HIGH RISK ADENOMAS

ESGE RESEARCH AWARD 2019
L Medina-Prado
1   Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain
,
C Mangas-Sanjuan
1   Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain
,
S Zarraquiños
2   Complexo Hospitalario Universitario de Orense, Ourense, Spain
,
E Rodríguez-Camacho
3   Dirección Xeral de Saúde Pública, Consellería de Sanidade, Santiago de Compostela, Spain
,
AH Aginagalde
4   Biocruces Health Research Institute, Barakaldo, Spain
,
AC Álvarez-Urturi
5   Hospital del Mar, Barcelona, Spain
,
J Cubiella
6   Complexo Hospitalario Universitario de Orense, Ouresen, Spain
,
I Portillo
4   Biocruces Health Research Institute, Barakaldo, Spain
,
M Pellisé
7   Hospital Clínic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
,
MJ Valverde
8   Servei de Promoció de la Salut i Prevenció en l’Entorn Sanitari. Subdirecció General de Promoció de la Salut i Prevenció, Valencia, Spain
,
D Salas
8   Servei de Promoció de la Salut i Prevenció en l’Entorn Sanitari. Subdirecció General de Promoció de la Salut i Prevenció, Valencia, Spain
,
R Jover
1   Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims Patients with ≥5 small adenomas or ≥1 adenoma ≥20mm are recommended to undergo one-year clearing colonoscopy according to the European guidelines. However, data from studies supporting this recommendation are not entirely consistent.

    The aim of this study was to evaluate one-year colonoscopy diagnostic yield based on advanced adenoma (AADR), CRC (CRCDR) and serrated polyps (SPDR) detection rates.

    Methods Descriptive, multicentric, cross-sectional study across four regions in Spain. Participants from organized FIT screening program between January 2014 and December 2015 were recruited. Inclusion criteria: ≥1 adenoma ≥20mm or ≥5 small adenomas. Exclusion criteria: incomplete procedure, inadequate colon cleansing, hereditary CRC syndromes and IBD.

    Results A total of 1876 patients were included (73.6% male; median age 62 years-old (range 49-72)). 48.9% of patients presented ≥5 small adenomas, 39.6% had ≥1 adenoma ≥20mm and 11.5% fulfilled both criteria. The median of colonoscopies needed for diagnosis was 1 (range 1-6) and checking the polypectomy scar (34.9%) was the main reason for repeating the procedure. The median of time from baseline colonoscopy to surveillance was 13.1 months (25thP 12.1-75thP 14.4).

    Detection rates during surveillance were: adenomas 58.2%, advanced adenomas 10%, serrated polyps 14.7%, advanced serrated polyps 2.5%, CRC 0.3% and advanced polyp detection rate 12.5%.

    Patients with ≥10 adenomas [OR1.85 (95%CI 1.21-2.84)], advanced adenomas located proximal to sigmoid [OR1.63 (95%CI 1.19-2.24)] and those with ≥5 serrated lesions [OR2.42 (95%CI 1.02-5.75)] had increased risk of advanced polyps during 1-year surveillance colonoscopy. In the multivariate analysis, only both criteria (≥1 adenoma ≥20mm or ≥5 small adenomas) was related with advanced polyps during one-year clearing colonoscopy [(OR2.96 (95%CI 1.29-6.83)].

    Conclusions In high-risk patients, advanced polyps detection rate was 12.5%, but only 0.3% of patients presented CRC. Patients who fulfilled both high-risk criteria benefit most from 1-year surveillance colonoscopy. It could be considered to extend the surveillance interval in the remaining patients.


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