Annual fecal occult blood testing combined with total colonoscopy is an efficient follow-up method for patients with colorectal adenoma. - A cohort study in worksite -

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  • 職域における大腸小腺腫の経過観察の検討
  • ショクイキ ニ オケル ダイチョウ ショウセンシュ ノ ケイカ カンサツ ノ ケントウ

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Abstract

Eight hundred thirty patients diagnosed with colorectal adenoma less than 5 mm in diameter by total colonoscopy (TCS) were classified into two groups, a “Simple Group” and a “Combined Group”, according to pathological and gross findings. The Simple Group included patients with severely atypical or surfaced type adenoma who were followed with TCS every 1 to 3 years. The Combined Group consisted of cases with mildly to moderately atypical and protruding-type adenoma followed with annual fecal occult blood testing (FOBT) combined with TCS every 5 years.<BR>The Combined Group was further subdivided into a “Positive Group” and a “Negative Group” based on FOBT results during follow-up. For comparison, individuals without colorectal adenomas or other lesions who underwent diagnostic colonoscopy following positive FOBT comprised the “Control Group”.<BR>The detection rates for advanced lesions such as adenomas more than 5 mm in diameter or carcinomas in the Simple, Positive and Negative Groups were compared with that of the Control Group. Lesion diameters between these groups were also compared. The detection rate in the Simple and Positive Groups was significantly higher than that in the Control Group. However, there was no significant difference in lesion diameter between these three groups.<BR>In contrast, the average diameter of colorectal adenomas in the Negative Group was significantly smaller than in the Control Group, although the detection rates were not significantly different. The average interval between TCS in the Simple, Positive and Negative Groups were 21, 27 and 52 months, respectively. <BR>We consider our follow-up system for colorectal adenoma to be effective measure for stratifying groups at risk for developing advanced lesions, which should potentially enable different clinical approaches to be applied to different groups.

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