| Theme | Average-risk colon cander screening | |
|---|---|---|
| Title | Post colonoscopic polypectomy surveillance program | |
| Publish Date | 2001/03 | |
| Author | Takahiro Kozu | Department of Internal Medicine, National Cancer Center Hospital |
| Author | Takahiro Fujii | Department of Internal Medicine, National Cancer Center Hospital |
| Author | Hiroyuki Ono | Department of Internal Medicine, National Cancer Center Hospital |
| Author | Yutaka Saito | Department of Internal Medicine, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Department of Internal Medicine, National Cancer Center Hospital |
| [ Summary ] | We evaluated this type of surveillance program by using the available literature and our retrospective study. In the literature available in Japan, there have been recommendations that there be short-term, second examinations after initial colonoscopy, for confirmation of a 'clean colon' and there shoud be follow-up examinations every two or three years after a 'clean colon' has been confirmed. However, recently for treatment of small polyps, less than 5mm in size, polypectomy has not thought to be necessary, because of their benign characteristics, such as slow growth and low malignancy rates. In addition, in view of the recent increase in the number of colonoscopic examinations, it is important to formulate adequate surveillance intervals and procedures for polypectomy patients. Our retrospective study showed that the incidence of index lesions (IL; adenoma over 10mm, adenoma with high grade atypia and mucosal cancer) depend on the findings gathered in initial examinations. Our analyzed results suggest the following : after initial examination, a second colonoscopy should be performed within at last six years, for patients not having polyps, four years for patients with small polyps under 5mm, and three years for patients with polyps over 6mm or mucosal cancer. However, we investigated retrospectively so incorrect data may be included. In practice, there is a possibility of developing shorter surveillance intervals, when we investigate prospectively. Prospective study is essential to develop adequate surveillance programs. Results are expected from Japanese prospective studies, which will be conducted in the near future. |
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