Incidence and Recurrence Rates of Advanced Colorectal Adenomas after removal with polypectomy among adult patients at St. Luke’s Medical Center – Global City: A Retrospective Cohort Study

Aims Colorectal cancer is the third most commonly diagnosed malignancy worldwide. It develops in a multi-step manner from normal epithelium, to a pre-malignant adenoma, and into a malignant carcinoma, hence surveillance colonoscopy is necessary. This study aims to determine the association of high-grade adenoma features and its risk of recurrence. This is critical in early diagnosis and treatment, thereby increasing the chance for good clinical outcomes [1] [2] [3].

Methods Eligible adult subjects are selected from the pathology data bank, and daily in-hospital census, who have advanced polyps detected during their first colonoscopy, and with at least 2 colonoscopies done from January 2019 to December 2023 in a tertiary hospital.

Results This study included 71 adult patients, with a mean age of 63 years old, and are mostly males. Among the high risk features, the following showed statistically significant p-values that contribute to the recurrence rate of advanced polyps: Family history of colon cancer (HR 1.59, p=0.003), Polyps more than 4mm in size (HR 1.80, p=0.04), More than one high grade polyp identified (HR 1.26, p=0.04), BBPS with a score 1 (HR 1.78, p=0.03), Tubulovillous morphology (HR 1.59, p=0.03), and Severe dysplasia (HR 1.98, p=0.02). The recurrence years also show that the risk is significantly higher within the first 1-2 years post-polypectomy (HR 1.16, p=0.003).

Conclusions This study strongly recommends scheduling a repeat colonoscopy one year after identifying advanced adenoma features during the initial procedure, as a local institutional recommendation.

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Weiszcyzy P. et.al. Colorectal Cancer Incidence and Mortality After Removal of Adenomas During Screening Colonoscopies...
• 2 Lieberman DA, Weiss DG, Bond JH. et al. Useofcolonoscopytoscreenasymptomaticadults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. N Engl J Med 2000; 343: 162-8
• 3 Yamaji Y. et.al. Incidenceandrecurrenceratesofcolorectaladenomasestimatedby annually repeated colonoscopies on asymptomatic Japanese...

Publication History

Article published online:
27 March 2025