Intest Res  
Three-year colonoscopy surveillance after polypectomy in Korea: a Korean Association for the Study of Intestinal Diseases multicenter prospective study
Won Seok Choi1, Dong Soo Han1, Chang Soo Eun1, Dong Il Park2, Jeong-Sik Byeon3, Dong-Hoon Yang3, Sung-Ae Jung4, Sang Kil Lee5, Sung Pil Hong5, Cheol Hee Park6, Suck-Ho Lee7, Jeong-Seon Ji8, Sung Jae Shin9, Bora Keum10, Hyun Soo Kim11, Jung Hye Choi1, Sin-Ho Jung12
1Department of Internal Medicine, Hanyang University Guri Hospital, Guri, 2Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, 3Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, 4Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, 5Department of Internal Medicine, Yonsei University College of Medicine, Seoul, 6Department of Internal Medicine, Hallym University Medical Center, Anyang, 7Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, 8Department of Internal Medicine, The Catholic University of Korea Incheon St. Mary’s Hospital, Incheon, 9Department of Internal Medicine, Ajou University School of Medinie, Suwon, 10Department of Internal Medicine, Korea University College of Medicine, Seoul, 11Department of Internal Medicine, Yonsei University College of Medicine, Wonju, Korea, 12Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
Correspondence to: Dong Soo Han, Department of Internal Medicine, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri 11923, Korea. Tel: +82-31-560-2226, Fax: +82-31-555-2998, E-mail: hands@hanyang.ac.kr
Received: April 18, 2017; Revised: July 19, 2017; Accepted: August 1, 2017; Published online: November 17, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: Colonoscopic surveillance is currently recommended after polypectomy owing to the risk of newly developed colonic neoplasia. However, few studies have investigated colonoscopy surveillance in Asia. This multicenter and prospective study was undertaken to assess the incidence of advanced adenoma based on baseline adenoma findings at 3 years after colonoscopic polypectomy. Methods: A total of 1,323 patients undergoing colonoscopic polypectomy were prospectively assigned to 3-year colonoscopy surveillance at 11 tertiary endoscopic centers. Relative risks for advanced adenoma after 3 years were calculated according to baseline adenoma characteristics. Results: Among 1,323 patients enrolled, 387 patients (29.3%) were followed up, and the mean follow-up interval was 31.0±9.8 months. The percentage of patients with advanced adenoma on baseline colonoscopy was higher in the surveillance group compared to the non-surveillance group (34.4% vs. 25.8%). Advanced adenoma recurrence was observed in 17 patients (4.4%) at follow-up. The risk of advanced adenoma recurrence was 2 times greater in patients with baseline advanced adenoma than in those with baseline non-advanced adenoma, though the difference was not statistically significant (6.8% [9/133] vs. 3.1% [8/254], P=0.09). Advanced adenoma recurrence was observed only in males and in subjects aged ≥50 years. In contrast, adenoma recurrence was observed in 187 patients (48.3%) at follow-up. Male sex, older age (≥50 years), and multiple adenomas (≥3) at baseline were independent risk factors for adenoma recurrence. Conclusions: A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.
Keywords: Colonoscopy; Colonic polyps; Surveillance; Recurrence; Adenoma


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