The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
Centre for Health Education and Health Promotion, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
J Gastroenterol Hepatol. 2023 Dec;38(12):2122-2129. doi: 10.1111/jgh.16367. Epub 2023 Sep 28.
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 5 year vs 7-10 years 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 7-10 years 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 109 768 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 10 years had a statistically higher recurrence rate of ACN than those followed-up at 5 year (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 5 years vs 7-10 years. These findings support a 7-10 years surveillance period after baseline NAA was polypectomized.
结直肠癌（CRC）是最常见的癌症之一，尤其是在亚洲人群中。我们比较了在基线结肠镜检查中发现并切除非进展性腺瘤（NAA）的个体中，晚期结直肠腺瘤（ACN）在 5 年与 7-10 年时的复发率。
我们从一个大型数据库（2008-2018 年）中提取了基线结肠镜检查中切除 NAA 并接受随访结肠镜检查的大量中国人群的数据。结果变量包括在随访结肠镜检查中 ACN 的复发情况。我们在控制结直肠癌危险因素的同时，检查了监测时间与结果变量之间的关联。
我们纳入了来自我们数据集的 109768 名接受基线结肠镜检查的患者。他们的年龄为 67.35（SD 9.84）岁，其中 60.9%为男性。ACN 的未经校正的 5 年和 10 年复发率分别为 1.50%和 2.42%（未经校正的优势比[OR]分别为 1.629，95%CI 1.362 至 1.949，P<0.001）。从二项逻辑回归模型中可以看出，与随访 5 年的患者相比，接受 10 年随访的患者 ACN 的复发率具有统计学意义更高（调整后的 OR[aOR]为 1.544，95%CI 1.266 至 1.877，P<0.001），但 aOR 的效应大小较小。
在接受 5 年与 7-10 年结肠镜检查的患者中，ACN 的复发率之间存在微小差异。这些发现支持在基线 NAA 切除后进行 7-10 年的监测期。
