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.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.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.doi http://dx.doi.org/10.1136/gutjnl-2018-318134
- dc.identifier.issn 0017-5749
- dc.identifier.uri http://hdl.handle.net/10230/46542
- 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.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Colonic polyps
- dc.subject.keyword Colorectal cancer
- dc.subject.keyword Polyposis
- 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.type.version info:eu-repo/semantics/publishedVersion