University of Twente Student Theses
Colonoscopic surveillance after colonoscopic polypectomy of a low-risk polyp: Incidence of invasive colorectal cancer, adenoma with high-grade dysplasia, and subsequent polyps
Eskes, H (2022) Colonoscopic surveillance after colonoscopic polypectomy of a low-risk polyp: Incidence of invasive colorectal cancer, adenoma with high-grade dysplasia, and subsequent polyps.
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| Abstract: | OBJECTIVE The aim of the study is to determine the incidence of CRC, adenomas with high-grade dysplasia, and subsequent polyps in patients who underwent a polypectomy of (a) low-risk polyp(s). OUTCOMES Primary outcomes were the incidence of CRC, adenomas with high-grade dysplasia, subsequent polyps, and CRC/Adenoma in patients initially classified as ‘low-risk’. Secondary outcomes were predictors for CRC/Adenoma and subsequent polyps, stratified for different follow-up time intervals (< 3 years, 3-5 years, and > 5 years). METHODS Patients included at MST underwent index colonoscopy with polypectomy from 2014 to 2017. Patients were either classified as low-risk or high-risk. Patients were followed until surveillance colonoscopy, diagnosis of CRC, or death, ending in 2021. Cox regression analyses were performed for primary outcomes and logistic regression analyses for secondary outcomes. RESULTS Of the 775 eligible patients, 450 were enrolled in the low-risk cohort (58.0% male; mean age, 62.8 ± 8.95 years; mean follow-up time 3.96 ± 1.87 years from index colonoscopy). For CRC, no significant risk factors were found. Increasing age (HR 1.02; 95% CI 1.00-1.03) and increased amount of polyps (HR 1.42; 95% CI 1.26-1.59) had an increased risk for subsequent polyps. For adenoma with high-grade dysplasia, both villous and tubulovillous adenoma compared to tubular adenoma (HR 11.8; 95% CI 1.22-115 and HR 7.24, 95% CI 1.44-36.5, respectively) had an increased risk and left-sided located polyps compared to right-sided (HR 0.09; 95% CI 0.01-0.78) had a lower risk. CRC/Adenoma had no significant risk factors. CONCLUSION No risk factors were found to be associated with the development of CRC and CRC/Adenoma. Age and amount of polyps are associated with the recurrence of subsequent polyps. Adenoma growth pattern and location are predictors for adenomas with high-grade dysplasia. |
| Item Type: | Essay (Master) |
| Clients: | Medisch Spectrum Twente, Enschede, Nederland |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/90818 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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