Follow-up After Removal of Polyps and Development of Colorectal Cancer
Posted: Monday, September 17, 2018
“Follow-up after removal of adenomas in normal daily practice is associated with a decrease in development of colorectal cancer,” reported Ruud J.L.F. Loffeld, PhD, of Zaans Medisch Centrum, Zaandam, The Netherlands, and colleagues in the Journal of Gastrointestinal Oncology. “However, to reach this many follow-up colonoscopies have to be done,” they added.
Their cross-sectional study included prospectively collected data on colonoscopy over 25 consecutive years at a community hospital in The Netherlands (Zaans Medisch Centrum). Included in this data set were patients who had a polyp removed during the index (first) procedure. A total of 34,531 procedures were performed over this time period, and in 9,356 cases (27%), hyperplastic, adenomatous, inflammatory, juvenile, and other polyps were found and removed.
The focus of the study was the 1,617 patients who had polypectomy and underwent follow-up procedures. Of these patients, 30 (1.9%) developed colorectal cancer, and the majority of these cancers were in the proximal colon (75%). The investigators noted that the mean time between cancer diagnosis and the previous colonoscopy was 70.6 months, with a median of 60.0 months.
Dr. Loffeld and colleagues noted that participation in the regular follow-up program was offered to all patients who had adenomas. They revealed, however, that passive follow-up policies may lead to “underperformance” of surveillance programs. The follow-up time in their study population spanned a wide range, from 0.5 to 23 years, with a mean follow-up of 11 years.