Endoscopy 2016; 48(01): 56-61
DOI: 10.1055/s-0034-1392515
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic surveillance in patients with multiple (10–100) colorectal polyps

Fátima Valentín
1  Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
,
Carla Guarinos
2  Unidad de Investigación, Hospital General Universitario de Alicante, Alicante, Spain
,
Miriam Juárez
3  Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain
,
María Rodríguez-Soler
2  Unidad de Investigación, Hospital General Universitario de Alicante, Alicante, Spain
,
Anna Serradesanferm
4  Unitat d’Avaluació, Suport i Prevenció, Hospital Clínic, Barcelona, Spain
,
Francisco Rodriguez-Moranta
5  Department of Gastroenterology, Bellvitge University Hospital, Hospitalet, Spain
,
David Nicolas-Perez
6  Department of Gastroenterology, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
,
Luis Bujanda
7  Department of Gastroenterology, Donostia Hospital/Biodonostia Institute, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University of Basque Country (UPV/EHU), San Sebastián, Spain
,
Maite Herraiz
8  Department of Gastroenterology, Clínica Universitaria de Navarra, Pamplona, Spain
,
Luisa De-Castro
9  Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
,
Fernando Fernández-Bañares
10  Department of Gastroenterology, Hospital Universitari Mutua de Terrassa, CIBERehd, Terrassa, Spain
,
Alberto Herreros-de-Tejada
11  Department of Gastroenterology, IDIPHIM, Hospital Universitario Puerta De Hierro, Majadahonda, Madrid, Spain
,
Fernando Martínez
12  Department of Gastroenterology, Instituto Valenciano de Oncología, Valencia, Spain
,
Elena Aguirre
13  Department of Oncology, Hospital Arnau de Vilanova, Lleida, Spain
,
Ángel Ferrández
14  Servicio de Aparato Digestivo, Hospital Clínico Universitario, IIS Aragón, University of Zaragoza, CIBERehd, Zaragoza, Spain
,
José Díaz-Tasende
15  Department of Gastroenterology, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Virginia Piñol
16  Department of Gastroenterology, Hospital Josep Trueta, Girona, Spain
,
Artemio Paya
17  Department of Pathology, Hospital General Universitario de Alicante, Alicante, Spain
,
Cecilia Egoavil
17  Department of Pathology, Hospital General Universitario de Alicante, Alicante, Spain
,
Cristina Alenda
17  Department of Pathology, Hospital General Universitario de Alicante, Alicante, Spain
,
Antoni Castells
18  Department of Gastroenterology, Hospital Clínic, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS, University of Barcelona, Barcelona, Spain
,
Rodrigo Jover
3  Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain
,
Joaquín Cubiella
1  Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
› Author Affiliations
Further Information

Publication History

submitted 18 October 2014

accepted after revision 14 May 2015

Publication Date:
10 July 2015 (online)

Background and study aims: Endoscopic surveillance in patients with multiple colorectal polyps aims to reduce colorectal cancer (CRC) incidence and mortality, as well as the need for colorectal surgery. The aim of this study was to determine the risk of developing CRC or the need for surgery during endoscopic surveillance in a cohort of patients with multiple (10 – 100) colorectal polyps.

Patients and methods: This was a multicentrer, longitudinal, observational study in 15 CRC high risk clinics in Spain, carried out between January 2009 and December 2010. Patients who were included in the EPIPOLIP trial and had at least 1 year of follow-up were included in the study. The primary outcome of interest was the incidence of CRC at least 1 year following the initial colonoscopy. The secondary outcome was the need for colorectal surgery.

Results: A total of 265 patients were followed for a median of 3.8 years. Patients underwent a median of 5 colonoscopies, and 17 patients (6.4 %) were diagnosed with CRC. A total of 32 patients (12.1 %) underwent surgery, including 15 (5.7 %) for prophylaxis without a diagnosis of CRC. The corresponding incidence density rates for CRC and colorectal surgery were 1.4 (95 % confidence interval [CI] 0.7 to 2.1) and 2.7 (95 %CI 1.7 to 3.6) per 100 patient-years, respectively. Only the presence of symptoms at first colonoscopy was independently associated with CRC diagnosis (hazard ratio [HR] 7.7, 95 %CI 1.1 to 59.3) and colorectal surgery (HR 4.6, 95 %CI 1.02 to 20.6).

Conclusions: Patients with more than 10 neoplastic polyps required frequent colonoscopies within a short follow-up period. More than 10 % of patients required colorectal surgery within 4 years, more than half for incident CRC.