Baseline colonoscopy results predict 10-year outcomes

Baseline colonoscopy results are highly predictive of 10-year outcomes and can be used to identify patients who could develop advanced neoplasia, Clinical Advisor reports.

Researchers published a study in Gastroenterology that examined 3,121 asymptomatic individuals between 50 and 75 years old. The individuals underwent a screening colonoscopy between 1994 and 1997 and were followed for 10 years.

After reviewing initial results, researchers split patients into cohorts. Patients with no neoplasia at baseline received either usual care or a follow-up examination at five years; patients with small adenomas received either usual care, follow-up exams at two years and five years, or a follow-up exam at five years; patients with advanced adenomas received follow-up exams at two years and five years; and patients with high-grade dysplasia or colorectal cancer received individualized care.

What they found:

1. About 146 patients among all baseline colonoscopy groups had at least one advanced neoplasia over 10 years.

2. Cumulative 10-year advanced neoplasia incidence rates were highest in the group with baseline CRC, followed by those with baseline advanced adenomas. Cumulative 10-year advanced neoplasia incidence rate was 6.3 percent for patients with small adenomas and 4.1 percent for patients with no neoplasia at baseline.

3. Researchers found patients with small adenomas or no baseline neoplasia faced no increased risk for developing either at follow-up examinations.

Researchers concluded, "Given the strong association of baseline findings with findings at subsequent examinations and the limited impact of known clinical factors, we hypothesize that genomic analysis may further clarify risk for CRC beyond the results of the baseline colonoscopy."

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