Table 4.
Risk of New Neoplasia at Follow-up, according to Baseline Patient and Adenoma Characteristics
| Characteristic | Number (%) | Non-advanced adenoma % (95% CI) | Advanced adenoma % (95% CI) | Cancer % (95% CI) |
|---|---|---|---|---|
|
| ||||
| Age, y | ||||
| < 40 | 154 (1.7) | 18.8 (12.7–25.0) | 3.9 (0.8–7.0) | 0.0 |
| 40–49 | 804 (8.8) | 27.7 (24.6–30.8) | 6.3 (4.7–8.0) | 0.1 (0.0–0.4) |
| 50–59 | 2397 (26.1) | 34.9 (33.0–36.8) | 8.6 (7.5–9.8) | 0.3 (0.1–0.6) |
| 60–69 | 3676 (40.1) | 36.0 (34.4–37.5) | 12.2 (11.1–13.2) | 0.6 (0.3–0.8) |
| 70–79 | 2074 (22.6) | 36.9 (34.9–39.0) | 14.5 (13.0–16.0) | 1.3 (0.8–1.7) |
| 80+ | 62 (0.7) | 33.9 (22.1–45.7) | 17.7 (8.2–27.3) | 1.6 (0.0–4.7) |
|
| ||||
| Sex | ||||
| Female | 2642 (28.8) | 29.0 (27.3–30.7) | 9.8 (8.7–10.9) | 0.3 (0.1–0.5) |
| Male | 6525 (71.2) | 37.3 (36.1–38.4) | 11.7 (10.9–12.5) | 0.8 (0.6–1.0) |
|
| ||||
| Race | ||||
| White | 8166 (89.1) | 35.0 (34.0–36.1) | 11.4 (10.7–12.0) | 0.6 (0.4–0.8) |
| Black | 527 (5.7) | 37.6 (33.4–41.7) | 10.4 (7.8–13.0) | 0.8 (0.0–1.5) |
| Other | 474 (5.2) | 29.1 (25.0–33.2) | 8.9 (6.3–11.4) | 1.3 (0.3–2.3) |
|
| ||||
| Family history of colorectal cancera | ||||
| No | 6547 (71.4) | 34.5 (33.4–35.7) | 11.0 (10.3–11.8) | 0.6 (0.4–0.8) |
| Yes | 2089 (22.8) | 36.7 (34.6–38.7) | 11.6 (10.3–13.0) | 0.6 (0.3–0.9) |
| Unknown | 531 (5.8) | 32.2 (28.2–36.2) | 11.1 (8.4–13.8) | 1.3 (0.3–2.3) |
|
| ||||
| Cigarette smoking statusb | ||||
| Never | 2805 (34.1) | 33.6 (31.9–35.4) | 11.1 (9.9–12.2) | 0.5 (0.2–0.8) |
| Former | 4081 (49.6) | 36.9 (35.4–38.4) | 12.1 (11.1–13.1) | 0.9 (0.6–1.2) |
| Current | 1299 (15.8) | 36.8 (34.2–39.4) | 11.8 (10.0–13.5) | 0.2 (0.0–0.5) |
| Unknown | 43 (0.5) | 34.9 (20.6–49.1) | 9.3 (0.6–18.0) | 2.3 (0.0–6.8) |
|
| ||||
| Body mass index (kg/m 2) c, d | ||||
| <25 | 2332 (28.4) | 32.2 (30.3–34.1) | 11.7 (10.4–13.1) | 0.5 (0.2–0.8) |
| 25–<30 | 3771 (45.9) | 36.6 (35.0–38.1) | 11.6 (10.6–12.7) | 0.7 (0.4–1.0) |
| 30+ | 2110 (25.7) | 38.1 (36.0–40.2) | 11.6 (10.2–12.9) | 0.8 (0.4–1.2) |
|
| ||||
| Previous Polype | ||||
| No Yes | 6941 (75.7) | 33.4 (32.3–34.5) | 9.8 (9.1–10.5) | 0.6 (0.4–0.8) |
| Unknown | 2057 (22.4) | 39.5 (37.4–41.6) | 15.2 (13.7–16.8) | 0.8 (0.4–1.2) |
| 169 (1.8) | 38.5 (31.1–45.8) | 16.6 (11.0–22.2) | 0.6 (0.0–1.7) | |
|
| ||||
| Adenoma Numberf | ||||
| 1 | 5465 (60.0) | 30.2 (29.0–31.4) | 8.6 (7.8–9.3) | 0.5 (0.4–0.7) |
| 2 | 2054 (22.5) | 38.3 (36.2–40.4) | 12.7 (11.3–14.1) | 0.5 (0.2–0.9) |
| 3 | 890 (9.8) | 45.4 (42.1–48.7) | 15.3 (12.9–17.6) | 1.1 (0.4–1.8) |
| 4 | 326 (3.6) | 45.4 (40.0–50.8) | 19.6 (15.3–23.9) | 1.2 (0.0–2.4) |
| 5+ | 377 (4.1) | 51.2 (46.1–56.2) | 24.1 (19.8–28.5) | 0.8 (0.0–1.7) |
|
| ||||
| Adenoma location | ||||
| Distal colorectum | 4434 (48.4) | 30.4 (29.1–31.8) | 8.5 (7.7–9.3) | 0.4 (0.2–0.6) |
| Proximal only | 2620 (28.6) | 37.3 (35.4–39.1) | 11.8 (10.6–13.1) | 0.8 (0.5–1.2) |
| Proximal and distal | 1754 (19.1) | 44.2 (41.9–46.6) | 17.5 (15.7–19.3) | 1.0 (0.6–1.5) |
| Unknown | 359 (3.9) | 26.7 (22.2–31.3) | 8.1 (5.3–10.9) | 0.0 |
|
| ||||
| Adenoma sizeg | ||||
| <5mm | 2540 (28.8) | 36.4 (34.5–38.3) | 7.7 (6.6–8.7) | 0.5 (0.2–0.8) |
| 5–<10 mm | 3115 (35.3) | 36.8 (35.1–38.5) | 8.7 (7.7–9.7) | 0.5 (0.2–0.7) |
| 10–<20mm | 2487 (28.2) | 31.4 (29.6–33.3) | 15.9 (14.5–17.4) | 0.8 (0.5–1.2) |
| 20+ mm | 672 (7.6) | 31.8 (28.3–35.4) | 19.3 (16.4–22.3) | 1.2 (0.4–2.0) |
|
| ||||
| Adenoma histology | ||||
| Tubularh | 7268 (79.3) | 35.1 (34.0–36.2) | 9.7 (9.0–10.4) | 0.6 (0.4–0.7) |
| Tubulovillous/villousi | 1899 (20.7) | 33.9 (31.8–36.0) | 16.8 (15.1–18.5) | 0.9 (0.5–1.4) |
|
| ||||
| High-grade dysplasiaj | ||||
| No | 6485 (90.5) | 35.3 (34.2–36.5) | 10.6 (9.8–11.3) | 0.5 (0.4–0.7) |
| Yes | 683 (9.5) | 35.9 (32.3–39.5) | 16.0 (13.2–18.7) | 1.3 (0.5–2.2) |
|
| ||||
| Low-risk groupk | 4644 (50.7) | 34.5 (33.1–35.8) | 6.9 (6.2–7.6) | 0.5 (0.3–0.7) |
| High-risk group | 4523 (49.3) | 35.3 (33.9–36.7) | 15.5 (14.5–16.6) | 0.8 (0.5–1.0) |
Percent of patients with a particular outcome reported during surveillance + standard error.
History of colorectal cancer in one or more parent, sibling, or child.
No data available for National Polyp Study participants (n=939)
Excludes 15 participants with missing data.
History of previous polyps or adenomas prior to qualifying colonoscopy; National Polyp Study and VA Cooperative Study included only participants with a first-time adenoma (n=1810).
Number of adenomas detected at qualifying examination; excludes 55 participants with missing data.
Size of largest adenoma; excludes 353 participants with missing data.
Includes participants with adenomas where histology was not specified, unknown, or other histologies (n=957).
One or more adenoma(s) with greater than 25% villous features.
One or more adenoma(s) with high-grade dysplasia. No data available for 1999 Calcium Polyp Prevention Study and Aspirin Folate Trial participants.
Defined according to the most recent surveillance guidelines3. The low-risk group includes patients with 1 to 2 small (less than 1 cm), tubular adenoma(s) with low-grade dysplasia; the high-risk group includes patients with 3 or more adenomas, or any adenomas 1 cm or larger in size, or with greater than 25% villous features, or with high-grade dysplasia.