Appropriateness of colonoscopy in Europe (EPAGE II). Surveillance after polypectomy and after resection of colorectal cancer.

Details

Serval ID
serval:BIB_1E2CB2453CEF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Appropriateness of colonoscopy in Europe (EPAGE II). Surveillance after polypectomy and after resection of colorectal cancer.
Journal
Endoscopy
Author(s)
Arditi C., Gonvers J.J., Burnand B., Minoli G., Oertli D., Lacaine F., Dubois R.W., Vader J.P., Schusselé Filliettaz S., Peytremann-Bridevaux I., Pittet V., Juillerat P., Froehlich F.
Working group(s)
EPAGE II Study Group
Contributor(s)
Agréus L., Beglinger C., Bytzer P., Delvaux M., Eckardt V., Fairclough P., Lacaine F., Le Moine O., Lorenzo-Zúñiga V., Minoli G., Numans M., Oertli D., O'Malley J., Windsor A.
ISSN
1438-8812 (Electronic)
ISSN-L
0013-726X
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
41
Number
3
Pages
209-217
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for surveillance after polypectomy and after curative-intent resection of colorectal cancer (CRC), and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II.
METHODS: A systematic search of guidelines, systematic reviews and primary studies regarding the evaluation and management of surveillance colonoscopy after polypectomy and after resection of CRC was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions.
RESULTS: Most CRCs arise from adenomatous polyps. The characteristics of removed polyps, especially the distinction between low-risk adenomas (1 or 2, small [< 1 cm], tubular, no high-grade dysplasia) vs. high-risk adenomas (large [> or = 1 cm], multiple [> 3], high-grade dysplasia or villous features), have an impact on advanced adenoma recurrence. Most guidelines recommend a 3-year follow-up colonoscopy for high-risk adenomas and a 5-year colonoscopy for low-risk adenomas. Despite the lack of evidence to support or refute any survival benefit for follow-up colonoscopy after curative-intent CRC resection, surveillance colonoscopy is recommended by most guidelines. The timing of the first surveillance colonoscopy differs. The expert panel considered that 56 % of the clinical indications for colonoscopy for surveillance after polypectomy were appropriate. For surveillance after CRC resection, it considered colonoscopy appropriate 1 year after resection.
CONCLUSIONS: Colonoscopy is recommended as a first-choice procedure for surveillance after polypectomy by all published guidelines and by the EPAGE II criteria. Despite the limitations of the published studies, colonoscopy is also recommended by most of the guidelines and by EPAGE II criteria for surveillance after curative-intent CRC resection.
Keywords
Colonoscopy, Colorectal Neoplasms/surgery, Europe, Guidelines as Topic, Humans, Intestinal Polyps/surgery, Postoperative Period
Pubmed
Web of science
Open Access
Yes
Create date
04/08/2009 10:05
Last modification date
20/08/2019 13:54
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