High compliance rates observed for follow up colonoscopy post polypectomy are achievable outside of clinical trials: efficacy of polypectomy is not reduced by low compliance for follow up.
High compliance rates observed for follow up colonoscopy post polypectomy are achievable outside of clinical trials: efficacy of polypectomy is not reduced by low compliance for follow up.
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DOI：
10.1111/j.1463-1318.2004.00585.x
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发表时间：
2004-05-01
期刊：
影响因子：
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通讯作者：
Wexner, S D
中科院分区：
文献类型：
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作者：
Colquhoun, P;Chen, H-C;Wexner, S D
简介：国家息肉研究表明，切除腺瘤并至少随访三年可降低结直肠癌的发病率。然而，遵守后续结肠镜检查可能会影响估计减少结直肠癌的发病率所证明的国家息肉研究。虽然在国家息肉研究期间实现了80%的随访结肠镜检查依从率，但在一般人群中随访结肠镜检查的依从率尚不清楚。本研究的目的是确定的依从性率为后续结肠镜检查和影响因素followup.METHODS：回顾性病历审查，以确定谁在1997年切除腺瘤性息肉的患者进行了。有炎症性肠病、结直肠癌、家族性腺瘤性息肉病综合征、结肠手术史、不完全息肉切除术或不完全结肠镜检查的患者以及在计划随访前死亡的患者从分析中排除。结果：共纳入333例患者，男196例，女147例，平均年龄70岁。333例患者中有331例（99%）有文件建议随访3年或更短时间，34%（113/333）既往接受过结肠镜检查，29%（98/333）既往接受过息肉切除术，54%（180/333）在结肠镜检查时有症状。28%（141人中的40人）有结直肠癌家族史。息肉切除术的病理学包括单个息肉和息肉小于10 mm分别占68%和88%。这些病例中有211例进行了随访，其中179例（85%）符合随访结肠镜检查要求。在单变量分析中，既往结肠镜检查（P = 0.035）、既往息肉（P = 0.043）、结肠镜检查时的无症状状态（P = 0.021）、息肉大小（P = 0.008）和息肉数量（P = 0.010）与患者是否依从随访结肠镜检查显著相关。多变量逻辑回归分析显示息肉数量（P = 0.036）和息肉大小（P = 0.045）是统计学上显着相关的compliance.CONCLUSION：符合息肉切除术后随访结肠镜检查大于80%，无论年龄，教育，家族史，以前的结肠镜检查，或以前的息肉切除术。国家息肉研究中发表的风险降低可能反映了通过普遍使用结肠镜进行监测可以实现的目标。
INTRODUCTION: The National Polyp Study demonstrated that removal of adenomas with at least a three-year follow up reduced the incidence of colorectal cancer. However, compliance with follow up colonoscopy may affect the estimates of reduction in colorectal cancer incidence demonstrated by the National Polyp Study. While an 80% compliance rate for follow up colonoscopy was achieved during the National Polyp Study, the compliance rate for follow up colonoscopy is unknown in the general population. The aim of this study was to determine the compliance rate for follow up colonoscopy and factors which affect follow up.METHODS: A retrospective medical record review to identify patients who had adenomatous polyps excised in 1997 was undertaken. Patients who had inflammatory bowel disease, a prior history of colorectal cancer, familial adenomatous polyposis syndrome, colonic surgery; incomplete polypectomy or incomplete colonoscopy, and those patients who died before planned follow up, were excluded from analysis. Follow up was performed by telephone survey.RESULTS: Three hundred and thirty-three patients were identified (196 males; 147 females) with a mean age of 70 years. Three hundred and thirty-one (99%) of 333 had a documented recommendation for follow up of three years or less. Thirty-four percent (113 of 333) had previously undergone colonoscopy; 29% (98 of 333) had previously undergone polypectomy and 54% (180 of 333) were symptomatic at the time of the colonoscopy. Twenty-eight percent (40 of 141) had a family history of colorectal cancer. Pathology at polypectomy included a single polyp and polyps less than 10 mm in 68% and 88% of cases, respectively. Follow up was available in 211 of these cases, 179 (85%) of which had been compliant with follow up colonoscopy. In a univariate analysis, previous colonoscopy (P = 0.035), previous polyps (P = 0.043), asymptomatic status at time of colonoscopy (P = 0.021), polyp size (P = 0.008) and number of polyps (P = 0.010) were significantly associated with patients who were compliant with follow up colonoscopy. A multivariate logistics regression analysis revealed number of polyps (P = 0.036) and polyp size (P = 0.045) to be statistically significantly associated with compliance.CONCLUSION: Compliance with follow up colonoscopy after polypectomy is greater than 80%, regardless of age, education, family history, prior colonoscopy, or prior polypectomy. Risk reduction published in the National Polyp Study may likely reflect what can be achieved through the general use of colonoscopy for surveillance.