Risk of recurrent advanced colorectal neoplasia in individuals with baseline non-advanced neoplasia followed up at 5 vs 7-10years.

Abstract

Colorectal cancer (CRC) is one of the commonest cancers, especially among the Asian populations. We compared the recurrence rate of advanced colorectal neoplasia (ACN) at 5year vs 7-10years among individuals with non-advanced adenoma (NAA) detected and polypectomized at baseline colonoscopy in a large Chinese population. We extracted data of a large Chinese population with NAA polypectomized who received surveillance colonoscopy after 5 or 7-10years from a large database (2008-2018). The outcome variable included recurrence of ACN at surveillance colonoscopy. We examined the association between length of surveillance and the outcome variable, whilst controlling for risk factors of colorectal cancer. We include 109768 subjects who have received a baseline colonoscopy from our dataset. They were aged 67.35 (SD 9.84) years, and 60.9% of them were male subjects. The crude 5-year and 10-year recurrence rate of ACN was 1.50% and 2.42%, respectively (crude odds ratio=1.629, 95% CI 1.362 to 1.949, P<0.001). From the binary logistic regression model, individuals with surveillance colonoscopy performed at 10years had a statistically higher recurrence rate of ACN than those followed-up at 5year (adjusted odds ratio [aOR]=1.544, 95% CI 1.266 to 1.877, P<0.001), but the effect size of aOR is small. There is a small difference in recurrence of ACN between individuals who received colonoscopy workup at 5years vs 7-10years. These findings support a 7-10years surveillance period after baseline NAA was polypectomized.