Abstract
Background and aims
Few reports address the appropriate colonoscopy surveillance interval for individuals
<50-years-old. We compared the risk of metachronous neoplasia among young (<50 years),
adult (50–74 years) and older (≥75 y) age groups.
Methods
This was a single center retrospective cohort study. Eligible subjects underwent their
first colonoscopy with polypectomy between 2005 and 2014 and had at least one surveillance
colonoscopy 3–5 years later. Patients (N = 495) were stratified at baseline into low-risk
adenoma (LRA) and advanced adenoma groups. Study outcomes were overall and high-risk
neoplasia at surveillance colonoscopy.
Results
In the baseline LRA-group (N = 201), the 5-year risk of metachronous high-risk neoplasia
was 12.5%, 15.2% and 22.5% (P = 0.426) in the young, adult and older age groups, respectively.
In the baseline advanced adenoma group (N = 294), the 3-year risk of metachronous
high-risk neoplasia was 13.3%, 14.8% and 25.3% (P = 0.041), respectively. In multivariate
analysis, the only risk factor for metachronous high-risk neoplasia was older age
(OR 1.876, CI 1.087–3.238; P = 0.024).
Conclusions
Considering the comparable risk of metachronous high-risk neoplasia in young and adult
patients, surveillance recommendations after polypectomy should not differ. Since
this risk is higher among older people, more frequent surveillance schedule can be
considered for this age group but should be individualized.
Keywords
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Article info
Publication history
Published online: February 06, 2020
Accepted:
December 31,
2019
Received:
May 28,
2019
Identification
Copyright
© 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
