{"id":7108,"date":"2020-01-12T19:37:57","date_gmt":"2020-01-12T18:37:57","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/?post_type=ec-news&#038;p=7108"},"modified":"2020-01-12T19:37:58","modified_gmt":"2020-01-12T18:37:58","slug":"brits-shake-up-postpolypectomy-surveillance","status":"publish","type":"ec-news","link":"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/brits-shake-up-postpolypectomy-surveillance\/","title":{"rendered":"Brits Shake Up Postpolypectomy Surveillance"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><em><strong>Douglas K. Rex, MD, FASGE reviewing Rutter MD, et al. Gut 2019 Nov 27.<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">British societies have always had their own postpolypectomy guidelines. Previous recommendations (compared to the U.S. Multi-Society Task Force on Colorectal Cancer recommendations used in the U.S.) had both a special higher risk group, for which 1-year surveillance was recommended, and a larger low-risk group.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The new British guideline uses the following definitions:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The high-risk group requires 2 premalignant polyps of which \u22651 is advanced (a serrated polyp \u226510 mm or having dysplasia OR an adenoma \u226510 mm or with high-grade dysplasia) OR \u22655 premalignant polyps.&nbsp;<\/li><li>\u201cPremalignant\u201d means any adenoma or serrated class polyp that is not a diminutive rectal hyperplastic polyp.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The key recommendations are:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Patients without high-risk findings should return to routine screening (which relies on fecal blood screening).<\/li><li>Patients with high-risk findings should have a \u201cone-off\u201d surveillance colonoscopy at 3 years.<\/li><li>Patients with a nonpedunculated lesion that is \u226520 mm and removed piecemeal should have a site check at 2 to 6 months and 1 year after that.<\/li><li>Surveillance should generally not occur if life expectancy is &lt;10 years or in patients older than about 75 years.<\/li><li>An exception to the above is a patient who is &gt;10 years younger than the lower recommended screening age who is found to have polyps but no high-risk criteria; follow-up colonoscopy in 5 or 10 years can be considered.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<figure class=\"wp-block-pullquote\" style=\"border-color:#bd6fb7\"><blockquote><p> COMMENT<br> It\u2019s interesting to see how other countries handle postpolypectomy surveillance, and this is a very radical revision of previous guidelines. The authors estimate that the new guidelines will reduce the colonoscopy surveillance workload to 20% of its current level. One of the interesting consequences is that resect and discard is fully enabled because adenomas &lt;10 mm and sessile serrated lesions and hyperplastic polyps &lt;10 mm (with the exception of 1- to 5-mm rectal hyperplastic polyps) are all considered equivalent in the guideline.<\/p><\/blockquote><\/figure>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made. <\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-media-text alignwide\" style=\"grid-template-columns:27% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"188\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/d-rex.jpg\" alt=\"\" class=\"wp-image-5921\"\/><\/figure><div class=\"wp-block-media-text__content\">\n<p class=\"has-large-font-size wp-block-paragraph\">Douglas K. Rex, MD, FASGE <\/p>\n<\/div><\/div>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">CITATION(S) <\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Rutter MD, East J, Rees CJ, et al. British Society of Gastroenterology\/Association of Coloproctology of Great Britain and Ireland\/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines.\u00a0<em>Gut\u00a0<\/em>2019 Nov 27. (Epub ahead of print) (<a rel=\"noreferrer noopener\" href=\"https:\/\/gut.bmj.com\/content\/69\/2\/201#block-system-main\" target=\"_blank\">https:\/\/gut.bmj.com\/content\/69\/2\/201#block-system-main<\/a>) <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Douglas K. Rex, MD, FASGE reviewing Rutter MD, et al. Gut 2019 Nov 27. British societies have always had their own postpolypectomy guidelines. Previous recommendations (compared to the U.S. Multi-Society Task Force on Colorectal Cancer recommendations used in the U.S.) had both a special higher risk group, for which 1-year surveillance was recommended, and a &#8230; <a title=\"Brits Shake Up Postpolypectomy Surveillance\" class=\"read-more\" href=\"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/brits-shake-up-postpolypectomy-surveillance\/\" aria-label=\"Read more about Brits Shake Up Postpolypectomy Surveillance\">Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1769],"tags":[1860],"class_list":["post-7108","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-asge-kolon","tag-postpolypectomy"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/7108","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=7108"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=7108"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=7108"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}