| Theme |
Can we change to treat for diminutive colorectal polyp ? |
| Title |
Colonoscopic intervals after removal of diminutive colorectal polyps |
| Author |
Nozomu Kobayashi |
Department of Diagnostic Imaging, Tochigi Cancer Center |
| Author |
Takahisa Matsuda |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Takahiro Fujii |
TF Clinic |
| Author |
Yasushi Sano |
Gastrointestinal Center, Sano Hospital |
| Author |
Yutaka Saito |
Endoscopy Division, National Cancer Center Hospital |
| [ Summary ] |
In western countries, surveillance intervals after removal of colorectal polyps are recommended based on the number, size and histology of polyps detected at the baseline colonoscopy. According to these guidelines, patients with diminutive polyps are at a lower risk of polyp recurrence compared to patients with larger polyps. However, patients with three or more diminutive polyps have an increased risk for adenomas, including advanced adenomas during the surveillance period. On the other hand, there are no recommendations or guidelines concerning colonoscopic intervals after polyp removal in Japan. To improve this situation, the Japan Polyp Study (JPS) Workgroup was organized in 2000. Based on the results of retrospective analysis, a multi-center prospective study to determine adequate surveillance intervals after the polyp removal was conducted in 2003. All scheduled examinations were finished by 2012. Data from the JPS revealed the importance not only of size but number of diminutive polyps. In conclusion, diminutive polyps are also one risk factor for polyp recurrence during surveillance. We should take into account these factors to establish Japanese guideline for colonoscopic surveillance after screening and polypectomy. |