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Personalised surveillance for serrated polyposis syndrome: results from a prospective 5-year international cohort study

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dc.contributor.author Bleijenberg, Arne G.C.
dc.contributor.author Bessa Caserras, Xavier
dc.contributor.author Dekker, Evelien
dc.date.accessioned 2021-02-19T08:00:16Z
dc.date.available 2021-02-19T08:00:16Z
dc.date.issued 2020
dc.identifier.citation Bleijenberg AG, IJspeert JE, van Herwaarden YJ, Carballal S, Pellisé M, Jung G, et al. Personalised surveillance for serrated polyposis syndrome: results from a prospective 5-year international cohort study. Gut. 2020 Jan; 69(1):112-21. DOI: 10.1136/gutjnl-2018-318134
dc.identifier.issn 0017-5749
dc.identifier.uri http://hdl.handle.net/10230/46542
dc.description.abstract Background and aims: Serrated polyposis syndrome (SPS) is associated with an increased risk of colorectal cancer (CRC). International guidelines recommend surveillance intervals of 1-2 years. However, yearly surveillance likely leads to overtreatment for many. We prospectively assessed a surveillance protocol aiming to safely reduce the burden of colonoscopies. Methods: Between 2013 and 2018, we enrolled SPS patients from nine Dutch and Spanish hospitals. Patients were surveilled using a protocol appointing either a 1-year or 2-year interval after each surveillance colonoscopy, based on polyp burden. Primary endpoint was the 5-year cumulative incidence of CRC and advanced neoplasia (AN) during surveillance. Results: We followed 271 SPS patients for a median of 3.6 years. During surveillance, two patients developed CRC (cumulative 5-year incidence 1.3%[95% CI 0% to 3.2%]). The 5-year AN incidence was 44% (95% CI 37% to 52%), and was lower for patients with SPS type III (26%) than for patients diagnosed with type I (53%) or type I and III (59%, p<0.001). Most patients were recommended a 2-year interval, and those recommended a 2-year interval were not at increased risk of AN: AN incidence after a 2-year recommendation was 15.6% compared with 24.4% after a 1-year recommendation (OR 0.57, p=0.08). Conclusion: Risk stratification substantially reduced colonoscopy burden while achieving CRC incidence similar to previous studies. AN incidence is considerable in SPS patients, but extension of surveillance intervals was not associated with increased AN in those identified as low-risk by the protocol. We identified SPS type III patients as low-risk group that might benefit from even less frequent surveillance.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.relation.ispartof Gut. 2020 Jan; 69(1):112-21.
dc.rights Copyright © Bleijenberg, Arne Gc .2020. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Personalised surveillance for serrated polyposis syndrome: results from a prospective 5-year international cohort study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1136/gutjnl-2018-318134
dc.subject.keyword Colonic polyps
dc.subject.keyword Colorectal cancer
dc.subject.keyword Polyposis
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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