Preneoplastic Colorectal Polyps: “I Found Them and Removed Them—Now What?”
Menée dans un contexte américain, cette étude compare le rapport coût-efficacité de deux stratégies de surveillance, l'une de faible intensité (10 ans après le retrait d'un adénome de faible risque et 5 ans après le retrait d'un adénome de haut risque) et l'autre de haute intensité (5 ans après le retrait d'un adénome de faible risque et 3 ans après le retrait d'un adénome de haut risque) chez des patients atteints d'un adénome colorectal et ayant participé au dépistage
One of our mentors used to say, “There is an infinite amount of human disease—one only needs to search for it.” But what happens when a finding that may indicate disease outstrips our knowledge of how to respond? Management of colorectal polyps is one such example. Increasing rates of screening; ever-improving, high-resolution endoscopes; and an emphasis on polyp detection as a measure of colonoscopy quality have increased the identification rate of preneoplastic adenomatous and serrated polyps. Some high-performing colonoscopy examiners now detect preneoplastic lesions in 50% to 60% of patients undergoing screening (1). Guidelines recommend that patients with preneoplastic polyps be followed with longitudinal colonoscopy surveillance to prevent colorectal cancer (CRC). The timing of surveillance is determined by the number, size, and histologic features of the removed lesions.
Annals of Internal Medicine , éditorial, 2018