Norshirwani et al used the number and size of adenomas removed at colonoscopy to predict recurrence. This can help determine how often a patient should be monitored with followup colonoscopies. The authors are from the Cleveland Clinic.
The repeat surveillance colonoscopy was performed 10-42 months after the first colonoscopy, with a mean interval of 18 months.
Outcome (termed outcome 1) was presence of 1 or more of the following in the followup colonoscopy:
(1) tubulovillous or villous adenoma
(2) high grade dysplasia or carcinoma in situ
(3) invasive carcinoma
(4) an adenoma >= 1 cm in size
Parameters:
(1) number of adenomas
(2) size of the largest adenoma in centimeters
Number of Adenomas
Size of Largest Adenoma
Percent with Outcome
1
< 1 cm
3%
1
>= 1 cm
8%
2
< 1 cm
4%
2
>= 1 cm
10%
3
< 1 cm
9%
3
>= 1 cm
21%
4
< 1 cm
15%
4
>= 1 cm
35%
after Table 5, page 436, with rounding of percent occurrence
If the percent occurrence at >= 1 cm is divided by percent occurrence at < 1 cm, the ratio is 2.3 to 2.7
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