A comparison of colonoscopy and double-contrast barium enema for surveillance after polypectomy Journal Article
| Authors: | Winawer, S. J.; Stewart, E. T.; Zauber, A. G.; Bond, J. H.; Ansel, H.; Waye, J. D.; Hall, D.; Hamlin, J. A.; Schapiro, M.; O'Brien, M. J.; Sternberg, S. S.; Gottlieb, L. S.; Hogan, W. J.; Khilnani, M.; Ackroyd, F. W.; Panish, J. F.; Kussin, L.; Edelman, M. |
| Article Title: | A comparison of colonoscopy and double-contrast barium enema for surveillance after polypectomy |
| Abstract: | Background: After patients have undergone colonoscopic polypectomy, it is uncertain whether colonoscopic examination or a barium enema is the better method of surveillance. Methods: As part of the National Polyp Study, we offered colonoscopic examination and double-contrast barium enema for surveillance to patients with newly diagnosed adenomatous polyps. Although barium enema was performed first, the endoscopist did not know the results. Results: A total of 973 patients underwent one or more colonoscopic examinations for surveillance. In the case of 580 of these patients, we performed 862 paired colonoscopic examinations and barium-enema examinations that met the requirements of the protocol. The findings on barium enema were positive in 222 (26 percent) of the paired examinations, including 94 of the 242 colonoscopic examinations in which one or more adenomas were detected (rate of detection of adenomas, 39 percent; 95 percent confidence interval, 33 to 45 percent). The proportion of examinations in which adenomatous polyps were detected by barium enema was significantly related to the size of the adenomas (P=0.009); the rate was 32 percent for colonoscopic examinations in which the largest adenomas detected were 0.5 cm or less, 53 percent for those in which the largest adenomas detected were 0.6 to 1.0 cm, and 48 percent for those in which the largest adenomas detected exceeded 1.0 cm. Among the 139 paired examinations with positive results on barium enema and negative results on colonoscopic examination in the same location, 19 additional polyps, 12 of which were adenomas, were detected on colonoscopic reexamination. Conclusions: In patients who have undergone colonoscopic polypectomy, colonoscopic examination is a more effective method of surveillance than double-contrast barium enema. (C) 2000, Massachusetts Medical Society. |
| Keywords: | adult; controlled study; middle aged; major clinical study; clinical trial; follow up; controlled clinical trial; randomized controlled trial; health survey; recurrence; clinical protocol; patient monitoring; adenoma; colonoscopy; multicenter study; long term care; intermethod comparison; double blind procedure; false negative reactions; colonic polyps; endoscopic polypectomy; colon adenoma; barium enema; single-blind method; enema; colon polyposis; barium sulfate; humans; human; male; female; priority journal; article; double contrast radiography |
| Journal Title: | New England Journal of Medicine |
| Volume: | 342 |
| Issue: | 24 |
| ISSN: | 0028-4793 |
| Publisher: | Massachusetts Medical Society |
| Date Published: | 2000-06-15 |
| Start Page: | 1766 |
| End Page: | 1772 |
| Language: | English |
| DOI: | 10.1056/nejm200006153422401 |
| PUBMED: | 10852998 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work