Long-term risk of colorectal cancer and related death after adenoma removal in a large, community-based population Journal Article


Authors: Lee, J. K.; Jensen, C. D.; Levin, T. R.; Doubeni, C. A.; Zauber, A. G.; Chubak, J.; Kamineni, A. S.; Schottinger, J. E.; Ghai, N. R.; Udaltsova, N.; Zhao, W. K.; Fireman, B. H.; Quesenberry, C. P.; Orav, E. J.; Skinner, C. S.; Halm, E. A.; Corley, D. A.
Article Title: Long-term risk of colorectal cancer and related death after adenoma removal in a large, community-based population
Abstract: Background & Aims: The long-term risks of colorectal cancer (CRC) and CRC-related death following adenoma removal are uncertain. Data are needed to inform evidence-based surveillance guidelines, which vary in follow-up recommendations for some polyp types. Using data from a large, community-based integrated health care setting, we examined the risks of CRC and related death by baseline colonoscopy adenoma findings. Methods: Participants at 21 medical centers underwent baseline colonoscopies from 2004 through 2010; findings were categorized as no-adenoma, low-risk adenoma, or high-risk adenoma. Participants were followed until the earliest of CRC diagnosis, death, health plan disenrollment, or December 31, 2017. Risks of CRC and related deaths among the high- and low-risk adenoma groups were compared with the no-adenoma group using Cox regression adjusting for confounders. Results: Among 186,046 patients, 64,422 met eligibility criteria (54.3% female; mean age, 61.6 ± 7.1 years; median follow-up time, 8.1 years from the baseline colonoscopy). Compared with the no-adenoma group (45,881 patients), the high-risk adenoma group (7563 patients) had a higher risk of CRC (hazard ratio [HR] 2.61; 95% confidence interval [CI] 1.87–3.63) and related death (HR 3.94; 95% CI 1.90–6.56), whereas the low-risk adenoma group (10,978 patients) did not have a significant increase in risk of CRC (HR 1.29; 95% CI 0.89–1.88) or related death (HR 0.65; 95% CI 0.19–2.18). Conclusions: With up to 14 years of follow-up, high-risk adenomas were associated with an increased risk of CRC and related death, supporting early colonoscopy surveillance. Low-risk adenomas were not associated with a significantly increased risk of CRC or related deaths. These results can inform current surveillance guidelines for high- and low-risk adenomas. © 2020 AGA Institute
Keywords: adult; controlled study; aged; major clinical study; cancer risk; follow up; colorectal cancer; cohort analysis; retrospective study; cancer mortality; health care; adenoma; colonoscopy; polyp; human; male; female; priority journal; article
Journal Title: Gastroenterology
Volume: 158
Issue: 4
ISSN: 0016-5085
Publisher: Elsevier Inc.  
Date Published: 2020-03-01
Start Page: 884
End Page: 894.e5
Language: English
DOI: 10.1053/j.gastro.2019.09.039
PUBMED: 31589872
PROVIDER: scopus
PMCID: PMC7083250
DOI/URL:
Notes: Article -- Export Date: 1 April 2020 -- Source: Scopus
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  1. Ann G Zauber
    314 Zauber