Document Detail


Colonoscopic surveillance of patients with a family history of colon cancer and a history of normal colonoscopy: is a five-year interval between colonoscopies appropriate?
MedLine Citation:
PMID:  15017673     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Patients with a family history of colon cancer are advised to undergo surveillance colonoscopy 5 years after a normal screening colonoscopy. No prospective study has evaluated the prevalence of adenomas found at surveillance colonoscopy in these patients. The aims of this trial were (1) to determine the percentage of these patients with adenomas; (2) to determine the percentage of these patients with advanced adenomas (i.e., villous adenomas, adenomas > or = 10 mm, adenomas with high grade dysplasia); and (3) to assess risk factors for adenomas in these patients. METHODS: Consecutive patients with a family history of colorectal cancer and a normal screening colonoscopy 5 years earlier were offered a surveillance colonoscopy. Patients also completed a questionnaire about potential risk factors for adenomas. Multiple logistic regression analysis assessed associations between risk factors and adenomas. RESULTS: One hundred patients completed the trial. The male/female ratio was 54/46, the mean age was 56.2 +/- 8.8 years, and 91% were white. Eight percent (8 of 100) of patients had advanced adenomas at surveillance colonoscopy, and 33% (33 of 100) had adenomas. Among patients with adenomas, 39% (13 of 33) had no adenomas in the left side of the colon (i.e., distal to the splenic flexure). Among patients with advanced adenomas, 25% (2 of 8) had no adenomas in the left side of the colon. Multiple logistic regression analysis showed a significant negative association between adenomas and NSAID use (odds ratio, 0.26 [95% confidence interval, 0.09-0.79]), and male gender had a positive association with adenomas (odds ratio, 2.79 [95% confidence interval, 1.01-7.74]). CONCLUSIONS: These data support a 5-year interval between screening and surveillance colonoscopy for patients with a family history of colorectal cancer and a normal screening colonoscopy.
Authors:
Philip S Schoenfeld; Roger Keith Fincher;
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  1     ISSN:  1542-3565     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2004-03-12     Completed Date:  2004-04-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  310-4     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, University of Michigan School of Medicine, Ann Arbor, MI, USA. pssmd@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adenoma / diagnosis*,  epidemiology*
Aged
Cecum / pathology
Colonic Neoplasms / diagnosis*,  epidemiology*
Colonoscopy*
Family Health
Female
Genetic Predisposition to Disease / epidemiology
Humans
Logistic Models
Male
Maryland
Middle Aged
Prospective Studies
Risk Factors
Severity of Illness Index
Statistics as Topic

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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