This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (8)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Gastrointestinal Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Marianne Ulcickas Yood, DSc, MPH; Susan Oliveria, ScD, MPH; J. Gregory Boyer, PhD; Karen Wells, BS; Paul Stang, PhD; Christine Cole Johnson, PhD, MPH

Arch Intern Med. 2003;163:422-426.

Background  Detection, treatment, and subsequent screening of patients with colorectal polyps have considerable implications for public health. Understanding the natural history of colorectal polyps from biologic and health care services standpoints is critical in determining optimal treatment.

Methods  Using computerized data from a large Midwestern health maintenance organization, we identified patients 50 years or older who underwent a polypectomy (index polypectomy) between January 1, 1989, and December 31, 1999. We followed up patients to identify subsequent polypectomies through September 1, 2001.

Results  Our final study sample consisted of 8865 individuals with an index polypectomy. Overall, 2704 patients (30.5%) were diagnosed as having recurrent polyps. Kaplan-Meier projections estimate that 50% of patients will have a recurrence within 7.6 years (95% confidence interval [CI], 7.2-8.1 years). Among patients who underwent colon screening at least 9 months after the index polypectomy (52% of original cohort), Kaplan-Meier projections estimate that 50% will have a recurrent polyp within 3.9 years (95% CI, 3.8-4.1 years).

Conclusions  The results demonstrate that, even when screening and treatment are received by those who need it, the risk of colon polyp recurrence is high and many patients do not undergo additional screening. Efforts to increase and monitor ongoing screening of postpolypectomy patients are warranted. In addition, further research is needed to better identify patients at risk for recurrence so that continued screening and other interventions can be targeted at these groups.

From Galt Associates, Sterling, Va (Drs Yood, Oliveria, and Stang); Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn (Dr Yood); Josephine Ford Cancer Center, Henry Ford Health System, Detroit, Mich (Drs Yood and Johnson and Ms Wells); and Pharmacia Corporation, Peapack, NJ (Dr Boyer).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Colorectal cancer (CRC) screening using sigmoidoscopy followed by colonoscopy: a feasibility and efficacy study on a cancer institute based population
Bleiberg et al.
Ann Oncol 2006;17:1328-1332.
ABSTRACT | FULL TEXT  

Project PREVENT: A Randomized Trial to Reduce Multiple Behavioral Risk Factors for Colon Cancer
Emmons et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:1453-1459.
ABSTRACT | FULL TEXT  

Surveillance Patterns and Polyp Recurrence following Diagnosis and Excision of Colorectal Polyps in a Medicare Population
Amonkar et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:417-421.
ABSTRACT | FULL TEXT