Colorectal Polyp Surveillance in a Single Gastroenterology Unit

Introduction: Colorectal cancer is a major cause of mortality and morbidity. The frequency of surveillance colonoscopy is an important clinical problem that demands attention. The American Gastroenterology Association and the British Society of Gastroenterology have suggested increasing interval between colonoscopies in patients with history of colorectal polyps.

Aim: To audit retrospectively polyp yield from surveillance colonoscopy in a cohort of patients with history of colorectal polyps

Methods: We identified patients with history of colorectal polyps who underwent surveillance colonoscopy over a 30-month period (January 2001– July 2003). Colonoscopy interval was 6 to 36 months. Patient with subsequent polyps were identified according to histology and location.

Results: 275 surveillance colonoscopies were performed 30 months period. The age range 18 to 91 years with a mean of 56 years. Male to female ratio 1:1.04.Histology: Adenomatous 138 patients (57%) with foci of invasive adenocarcinoma 5 patients (2%).Hyperplasic polyps 63 patients (26%).Other benign pathology 30 patients (12%).Location:30% rectal, 30% sigmoid, 11% descending, 7% transverse, 4% ascending,5% caecum and 12% nonspecified.

Conclusion: The polyp recurrence rate was higher than expected. Malignancy was seen in 5 patients, all had colonic surgery. Irish population may behave differently from Americans and different guidelines for surveillance may be required.