Risk of Metachronous Advanced Neoplasia in Patients With Multiple Diminutive Adenomas
- Authors
- Kim, JY[Kim, Jung Yoon]; Kim, TJ[Kim, Tae Jun]; Baek, SY[Baek, Sun-Young]; Ahn, S[Ahn, Soohyun]; Kim, ER[Kim, Eun Ran]; Hong, SN[Hong, Sung Noh]; Chang, DK[Chang, Dong Kyung]; Kim, YH[Kim, Young-Ho]
- Issue Date
- Dec-2018
- Publisher
- NATURE PUBLISHING GROUP
- Citation
- AMERICAN JOURNAL OF GASTROENTEROLOGY, v.113, no.12, pp.1855 - 1861
- Indexed
- SCIE
SCOPUS
- Journal Title
- AMERICAN JOURNAL OF GASTROENTEROLOGY
- Volume
- 113
- Number
- 12
- Start Page
- 1855
- End Page
- 1861
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/16512
- DOI
- 10.1038/s41395-018-0210-9
- ISSN
- 0002-9270
- Abstract
- OBJECTIVES: Individuals with advanced adenomas or three or more adenomas have a higher risk of metachronous advanced neoplasia (AN) and are recommended to undergo surveillance colonoscopy at shorter intervals. However, it is questionable whether patients with multiple (three or more) non-advanced diminutive adenomas should be considered as high-risk. METHODS: We analyzed 5482 patients diagnosed with one or more adenomas during their first colonoscopy screening and who underwent a follow-up colonoscopy. Patients were categorized into four groups based on adenoma characteristics at baseline: Group 1, 1-2 non-advanced adenomas; Group 2, >= 3 non-advanced, diminutive (1 to 5 mm) adenomas; Group 3, >= 3 non-advanced, small (6-9 mm) adenomas; and Group 4, advanced adenomas. RESULTS: During a median follow-up of 38 months, the incidence of metachronous AN at surveillance colonoscopy was 5.6%. The incidence of AN was 3.9% in group 1, 5.9% in group 2, 10.6% in group 3, and 22.1% in group 4. The adjusted hazard ratios (HRs) [95% confidence intervals (CIs)] for metachronous AN between group 2, group 3, and group 4, and low risk group 1 were 1.71 (0.99-2.94), 2.76 (1.72-4.44), and 5.23 (3.57-7.68), respectively. Compared with group 4, the adjusted HRs (95% CIs) for group 1, group 2, and group 3 were 0.19 (0.13-0.28), 0.32 (0.18-0.59), and 0.52 (0.31-0.89), respectively. CONCLUSIONS: We found that patients with three or more non-advanced diminutive adenomas had a borderline increased risk of metachronous AN compared with patients with low risk adenomas.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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