Should We Shorten or Lengthen Postpolypectomy Surveillance Intervals?
Authors: Douglas K. Rex, Sidney J. Winawer
Journal: Annals of Internal Medicine (2008)

Letters2 September 2008Should We Shorten or Lengthen Postpolypectomy Surveillance Intervals?Douglas K. Rex, MD and Sidney J. Winawer, MDDouglas K. Rex, MDFrom Indiana University School of Medicine, Indianapolis, IN 46202, and Memorial Sloan-Kettering Cancer Center, New York, NY 10065.Search for more papers by this author and Sidney J. Winawer, MDFrom Indiana University School of Medicine, Indianapolis, IN 46202, and Memorial Sloan-Kettering Cancer Center, New York, NY 10065.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-5-200809020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their recent article, Laiyemo and colleagues (1) were critical of the discriminatory value of current postpolypectomy surveillance guidelines, including the joint guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer and the American Cancer Society (USMSTF–ACS). In the past 15 years, usual postpolypectomy practice surveillance intervals have expanded, first from 1 to 3 years and then from 3 to 5 years, in the cohort considered to be at lowest risk. The rationale for interval expansion is that surveillance has risks, costs, and less value than baseline clearing examinations in preventing cancer (2). We are concerned ...References1. Laiyemo AO, Murphy G, Albert PS, Sansbury LB, Wang Z, Cross AJ, et al. Postpolypectomy colonoscopy surveillance guidelines: predictive accuracy for advanced adenoma at 4 years. Ann Intern Med. 2008;148:419-26. [PMID: 18347350] LinkGoogle Scholar2. Zauber A, Winawer SJ, Lansdorp-Vogelaar I, van Ballegooijen M, O'Brien MJ. Effect of initial polypectomy versus surveillance polypectomy on colorectal cancer mortality reduction: micro-simulation modeling of the National Polyp Study. Am J Gastroenterol. 2007;102:S558. CrossrefMedlineGoogle Scholar3. Imperiale TF, Sox HC. Guidelines for surveillance intervals after polypectomy: coping with the evidence [Editorial]. Ann Intern Med. 2008;148:477-9. [PMID: 18347353] LinkGoogle Scholar4. Winawer SJ, Zauber AG, Fletcher RH, Stillman JS, O'Brien MJ, Levin B, et al; US Multi-Society Task Force on Colorectal Cancer. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology. 2006;130:1872-85. [PMID: 16697750] CrossrefMedlineGoogle Scholar5. Chen SC, Rex DK. Endoscopist can be more powerful than age and male gender in predicting adenoma detection at colonoscopy. Am J Gastroenterol. 2007;102:856-61. [PMID: 17222317] CrossrefMedlineGoogle Scholar6. Barclay RL, Vicari JJ, Doughty AS, Johanson JF, Greenlaw RL. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med. 2006;355:2533-41. [PMID: 17167136] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Indiana University School of Medicine, Indianapolis, IN 46202, and Memorial Sloan-Kettering Cancer Center, New York, NY 10065.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPostpolypectomy Colonoscopy Surveillance Guidelines: Predictive Accuracy for Advanced Adenoma at 4 Years Adeyinka O. Laiyemo , Gwen Murphy , Paul S. Albert , Leah B. Sansbury , Zhuoqiao Wang , Amanda J. Cross , Pamela M. Marcus , Bette Caan , James R. Marshall , Peter Lance , Electra D. Paskett , Joel Weissfeld , Martha L. Slattery , Randall Burt , Frank Iber , Moshe Shike , J. Walter Kikendall , Elaine Lanza , and Arthur Schatzkin Guidelines for Surveillance Intervals after Polypectomy: Coping with the Evidence Thomas F. Imperiale and Harold C. Sox Should We Shorten or Lengthen Postpolypectomy Surveillance Intervals? Adeyinka O. Laiyemo , Elaine Lanza , and Arthur Schatzkin Metrics Cited byLa coloscopie en France en 2008: résultats de l’enquête de deux jours d’endoscopie en FranceAdvanced vs. “High-Risk” Adenomas: Identifying the Relevant Target for CT Colonography Screening 2 September 2008Volume 149, Issue 5Page: 360KeywordsAdenomasBiomarkersCancer preventionCancer risk factorsColonoscopyColorectal cancerConflicts of interestDysplasiaMedical risk factorsSafety ePublished: 2 September 2008 Issue Published: 2 September 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...