OPEN IN READ APP
JOURNAL ARTICLE

Long-term Risk of Colorectal Cancer and Related Death After Adenoma Removal in a Large, Community-based Population

Jeffrey K Lee, Christopher D Jensen, Theodore R Levin, Chyke A Doubeni, Ann G Zauber, Jessica Chubak, Aruna S Kamineni, Joanne E Schottinger, Nirupa R Ghai, Natalia Udaltsova, Wei K Zhao, Bruce H Fireman, Charles P Quesenberry, E John Orav, Celette Sugg Skinner, Ethan A Halm, Douglas A Corley
Gastroenterology 2019 October 4
31589872

BACKGROUND & AIMS: The long-term risks of colorectal cancer (CRC) and CRC-related death following adenoma removal are uncertain. Data are needed to inform evidence-based surveillance guidelines, which vary in follow-up recommendations for some polyp types. Using data from a large, community-based integrated health care setting, we examined the risks of CRC and related death by baseline colonoscopy adenoma findings.

METHODS: Participants at 21 medical centers underwent baseline colonoscopies from 2004 through 2010; findings were categorized as no adenoma, low-risk adenoma, or high-risk adenoma. Participants were followed until the earliest of CRC diagnosis, death, health plan disenrollment, or December 31, 2017. Risks of CRC and related deaths among the high- and low-risk adenoma groups were compared with the no adenoma group using Cox regression adjusting for confounders.

RESULTS: Among 186,046 patients, 64,422 met eligibility criteria (54.3% female; mean age, 61.6±7.1 y; median follow-up time, 8.1 y from the baseline colonoscopy). Compared with the no-adenoma group (45,881 patients), the high-risk adenoma group (7563 patients) had a higher risk of CRC (hazard ratio [HR], 2.61; 95% CI, 1.87-3.63) and related death (HR, 3.94; 95% CI, 1.90-6.56), whereas the low-risk adenoma group (10,978 patients) did not have a significant increase in risk of CRC (HR, 1.29; 95% confidence interval, 0.89-1.88) or related death (HR, 0.65; 95% CI, 0.19-2.18).

CONCLUSIONS: With up to 14-years of follow-up, high-risk adenomas were associated with an increased risk of CRC and related death, supporting early colonoscopy surveillance. Low-risk adenomas were not associated with a significantly increased risk of CRC or related deaths. These results can inform current surveillance guidelines for high- and low-risk adenomas.

Comments

You need to log in or sign up for an account to be able to comment.

No comments yet, be the first to post one!

Trending on Read

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
31589872
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"