Abstract
Background
Current post-polypectomy guidelines do not consider adenoma location. We compared
the risk of metachronous colorectal neoplasia (CRN) according to adenoma location.
Methods
We collected data from 9710 patients who underwent follow-up colonoscopy after adenoma
removal. Patients were classified according to baseline adenoma location: distal only
(n=4665), proximal only (n=3827), and both sides (n=1218).
Results
The risk of metachronous CRN in patients with proximal only adenomas was higher than
that in those with distal only adenomas (adjusted hazard ratio [aHR]=1.12, 95% confidence
interval [CI]=1.04–1.21), while the risk of metachronous advanced CRN (ACRN) was not
different between the two groups. Among patients aged <50 years, the risk of metachronous
CRN in those with proximal only non-advanced adenomas (NAAs) was higher than that
in those with only distal NAAs, while among patients aged ≥ 50 years, the risk in
those with proximal only advanced adenomas (AAs) was higher than that in those with
distal only AAs. However, the risk of metachronous ACRN did not differ based on adenoma
location in patients aged < 50 and ≥ 50 years.
Conclusions
Proximal adenoma was associated with an increased risk of metachronous CRN, but not
with an increased risk of metachronous ACRN, supporting the current guidelines recommending
the same surveillance interval for distal and proximal adenoma without discrimination
by adenoma location.
Keywords
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Article info
Publication history
Published online: August 22, 2021
Accepted:
August 4,
2021
Received in revised form:
August 3,
2021
Received:
July 4,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
