10-year follow-up appropriate for some

In patients with prior adenoma, information from previous colonoscopies may help identify low-risk patients who are unlikely to benefit from intense surveillance, a study finds. The researchers followed 564 patients participating in the Aspirin/Folate Polyp Prevention Study who had had one or more adenomas discovered in an initial colonoscopy. A second examination was conducted about 3 years later, again with removal of all detected polyps, and a third exam was done either 3 or 5 years after the second. Patients with cancers found at or before the second exam were excluded from the study. Advanced adenomas were classified as 1 cm or larger, with tubulovillous or villous histologic features or high-grade dysplasia. High-risk findings were at least 3 adenomas or at least 1 advanced adenoma. At the third examination, 10% of subjects had high-risk findings, the researchers found. If the second examination showed high-risk findings, then results from the first examination added no significant information about the probability of high-risk findings on the third examination (18.2% for high-risk findings on the first examination vs. 20.0% for low-risk findings on the first examination; P = 0.78). If the second examination showed no adenomas, then the results from the first examination added significant information about the probability of high-risk findings on the third examination (12.3% if the first examination had high-risk findings vs. 4.9% if the first examination had low-risk findings; P = 0.015)....