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First colonoscopy with removal of polyps linked to reduction in colon cancer death
Date:10/15/2007

to five years for follow-up of patients with prior colorectal cancer, prior adenomas or disease with causes increased risk of colorectal cancer.

An editorial by colorectal cancer expert T.R. Levin, M.D, FACG in the August issue of the American Journal of Gastroenterology offers an overview of post-polypectomy surveillance. According to Dr. Levin: Postpolypectomy and postcancer resection surveillance are among the most common indications for colonoscopy in clinical practice. Together, they account for more than one in five colonoscopies in the Clinical Outcomes Research Initiative (CORI) database. Survey results have also demonstrated that postpolypectomy surveillance for small adenomas and hyperplastic polyps is often recommended by specialists and primary care physicians more frequently than guideline recommendations.* Dr. Levin commented on a study in the same issue of the American Journal of Gastroenterology by Brenner et al. from Germany which Levin believes presents additional evidence to justify extending colonoscopy intervals following polypectomy to five years. According to Levin, performing excessive surveillance colonoscopy is a problem for two reasons. It drains resources better used for initial colorectal cancer screening and diagnosis, and patients are exposed to potential risks associated with each colonoscopy with little benefit.

According to ACG President Dr. David A. Johnson, there is growing evidence to support the extension of surveillance to longer intervals, all subject to optimal clearing of the colon of precancerous polyps which is contingent on adequate resection at the time of polypectomy and adequate visualization of the colon, which depends on adequate bowel preparation, as well as efforts by the endoscopist during the exam. Although given the constraints of a modeling study such as this one from Sloan-Kettering, there need to be prospective trials to support and validate longer colorectal cancer surveillance int
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Contact: Rosanne Riesenman
mediaonly@acg.gi.org
301-263-9000
American College of Gastroenterology
Source:Eurekalert

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