Intensity of Surveillance for Patients With Colorectal Adenomas
Authors: Samir Gupta, David Lieberman
Journal: Annals of Internal Medicine (2020)

Letters17 March 2020Intensity of Surveillance for Patients With Colorectal AdenomasSamir Gupta, MD, MSCS and David Lieberman, MDSamir Gupta, MD, MSCSVA San Diego Healthcare System and University of California San Diego, San Diego, California (S.G.)Search for more papers by this author and David Lieberman, MDOregon Health and Science University, Portland, Oregon (D.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0828 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Meester and colleagues (1) conclude that high-intensity surveillance colonoscopy (that is, 3 years for high-risk adenomas [HRAs] and 5 years for low-risk adenomas [LRAs]) was cost-effective compared with low-intensity surveillance (that is, 5 years for HRAs and 10 years for LRAs). Because most patients with adenomas have LRAs (defined as 1 to 2 adenomas <10 mm in diameter), findings for patients with LRAs require particularly careful assessment. Modeled cumulative risk for colorectal cancer (CRC) in patients with LRAs at baseline was 7% at 10 years and 10.9% after 30 years. These values qualitatively seem much higher than those ...References1. Meester RGS, Lansdorp-Vogelaar I, Winawer SJ, et al. High-intensity versus low-intensity surveillance for patients with colorectal adenomas. A cost-effectiveness analysis. Ann Intern Med. 2019;171:612-22. [PMID: 31546257]. doi:10.7326/M18-3633 LinkGoogle Scholar2. Click B, Pinsky PF, Hickey T, et al. Association of colonoscopy adenoma findings with long-term colorectal cancer incidence. JAMA. 2018;319:2021-31. [PMID: 29800214] doi:10.1001/jama.2018.5809 CrossrefMedlineGoogle Scholar3. He X, Hang D, Wu K, et al. Long-term risk of colorectal cancer after removal of conventional adenomas and serrated polyps. Gastroenterology. 2019. [PMID: 31302144] doi:10.1053/j.gastro.2019.06.039 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: VA San Diego Healthcare System and University of California San Diego, San Diego, California (S.G.)Oregon Health and Science University, Portland, Oregon (D.L.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0828. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHigh-Intensity Versus Low-Intensity Surveillance for Patients With Colorectal Adenomas Reinier G.S. Meester , Iris Lansdorp-Vogelaar , Sidney J. Winawer , Ann G. Zauber , Amy B. Knudsen , and Uri Ladabaum Intensity of Surveillance for Patients With Colorectal Adenomas Reinier G.S. Meester , Iris Lansdorp-Vogelaar , Sidney J. Winawer , Ann G. Zauber , Amy B. Knudsen , and Uri Ladabaum Metrics 17 March 2020Volume 172, Issue 6Page: 441-442KeywordsAdenomasCancer screeningCohort studiesColonoscopyColorectal cancerDisclosureObservational studiesPrevention, policy, and public healthRandomized trialsRisk management ePublished: 17 March 2020 Issue Published: 17 March 2020 PDF downloadLoading ...