Surveillance of colonic polyps: are we getting it right?

被引:53
作者
Bonnington, Stewart N. [1 ,2 ]
Rutter, Matthew D. [1 ,2 ]
机构
[1] Univ Hosp North Tees, Dept Gastroenterol, Hardwick Rd, Stockton On Tees TS19 8PE, England
[2] Univ Durham, Stockton On Tees TS17 6BH, England
关键词
Adenoma; polyp; colonoscopy; surveillance; colorectal cancer; LONG-TERM RISK; COLORECTAL-CANCER; NATURAL-HISTORY; FOLLOW-UP; COLONOSCOPY SURVEILLANCE; SCREENING COLONOSCOPY; ASYMPTOMATIC ADULTS; ADVANCED NEOPLASIA; ADENOMA DETECTION; NATIONAL POLYP;
D O I
10.3748/wjg.v22.i6.1925
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. The identification of colonic polyps can reduce CRC mortality through earlier diagnosis of cancers and the removal of polyps: the removal of colonic polyps at an initial colonoscopy, some patients are at an increased risk of developing CRC in the future. This is the rationale for post-polypectomy surveillance colonoscopy. However, not all individuals found to have colonic adenomas have a risk of CRC higher than that of the general population. This review examines the literature on post-polypectomy surveillance including current international clinical guidelines. The potential benefits of surveillance procedures must be weighed against the burden of colonoscopy: resource use, the potential for patient discomfort, and the risk of complications. Therefore surveillance colonoscopy is best utilised in a selected group of individuals at a high risk of developing cancer. Further study is needed into the specific factors conferring higher risk as well as the efficacy of surveillance in mitigating this risk. Such evidence will better inform clinicians and patients of the relative benefits of colonoscopic surveillance for the individual. In addition, the decision to continue with surveillance must be informed by the changing profile of risks and benefits of further procedures with the patient's advancing age.
引用
收藏
页码:1925 / 1934
页数:10
相关论文
共 81 条
  • [1] [Anonymous], 2014, Colorectal cancer facts & figures 2014-2016
  • [2] Severe imbalance of cell proliferation and apoptosis in the left colon and in the rectosigmoid tract in subjects with a history of large adenomas
    Anti, M
    Armuzzi, A
    Morini, S
    Iascone, E
    Pignataro, G
    Coco, C
    Lorenzetti, R
    Paolucci, M
    Covino, M
    Gasbarrini, A
    Vecchio, FM
    Gasbarrini, G
    [J]. GUT, 2001, 48 (02) : 238 - 246
  • [3] Colorectal cancer screening Randomised trials of flexible sigmoidoscopy
    Atkin, Wendy
    Kralj-Hans, Ines
    Wardle, Jane
    Duffy, Stephen
    [J]. BRITISH MEDICAL JOURNAL, 2010, 341
  • [4] Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial
    Atkin, Wendy S.
    Edwards, Rob
    Kralj-Hans, Ines
    Wooldrage, Kate
    Hart, Andrew R.
    Northover, John M. A.
    Parkin, D. Max
    Wardle, Jane
    Duffy, Stephen W.
    Cuzick, Jack
    [J]. LANCET, 2010, 375 (9726) : 1624 - 1633
  • [5] LONG-TERM RISK OF COLORECTAL-CANCER AFTER EXCISION OF RECTOSIGMOID ADENOMAS
    ATKIN, WS
    MORSON, BC
    CUZICK, J
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1992, 326 (10) : 658 - 662
  • [6] Colonoscopic withdrawal times and adenoma detection during screening colonoscopy
    Barclay, Robert L.
    Vicari, Joseph J.
    Doughty, Andrea S.
    Johanson, John F.
    Greenlaw, Roger L.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2006, 355 (24) : 2533 - 2541
  • [7] Association of Colonoscopy and Death From Colorectal Cancer
    Baxter, Nancy N.
    Goldwasser, Meredith A.
    Paszat, Lawrence F.
    Saskin, Refik
    Urbach, David R.
    Rabeneck, Linda
    [J]. ANNALS OF INTERNAL MEDICINE, 2009, 150 (01) : 1 - W1
  • [8] Risk of progression of advanced adenomas to colorectal cancer by age and sex: estimates based on 840 149 screening colonoscopies
    Brenner, Hermann
    Hoffmeister, Michael
    Stegmaier, Christa
    Brenner, Gerhard
    Altenhofen, Lutz
    Haug, Ulrike
    [J]. GUT, 2007, 56 (11) : 1585 - 1589
  • [9] Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies
    Brenner, Hermann
    Stock, Christian
    Hoffmeister, Michael
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2014, 348
  • [10] Role of Colonoscopy and Polyp Characteristics in Colorectal Cancer After Colonoscopic Polyp Detection A Population-Based Case-Control Study
    Brenner, Hermann
    Chang-Claude, Jenny
    Jansen, Lina
    Seiler, Christoph M.
    Hoffmeister, Michael
    [J]. ANNALS OF INTERNAL MEDICINE, 2012, 157 (04) : 225 - 233