Scientific publications

Endoscopic surveillance after colonic polyps and colorrectal cancer resection. 2018 update

Mangas-Sanjuan C 1, Jover R 2, Cubiella J 3, Marzo-Castillejo M 4, Balaguer F 5, Bessa X 6, Bujanda L 7, Bustamante M 8, Castells A 5, Diaz-Tasende J 9, Díez-Redondo P 10, Herráiz M (11), Mascort-Roca JJ (12), Pellisé M (5), Quintero E (13); Grupo de Cribado del Cáncer Colorrectal de la Sociedad Española de Epidemiología.

(1) Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitario de Alicante, Alicante, España.
(2" Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitario de Alicante, Alicante, España.
(3) Servicio de Aparato Digestivo, Complexo Hospitalario Universitario de Ourense, Instituto de Investigación Sanitaria Galicia Sur, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Ourense, España.
(4) Unitat de Suport a la Recerca Metropolitana Sud-Institut d'Investigació en Atenció Primaria (IDIAP), Cornellà de Llobregat, Barcelona, España.
(5) Servicio de Gastroenterología, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, España.
(6) Servicio de Aparato Digestivo, Hospital del Mar, Barcelona, España.
(7) Hospital Donostia/Instituto Biodonostia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad del País Vasco, San Sebastián, Guipúzcoa, España.
(8) Servicio de Aparato Digestivo, Hospital Universitari i Politècnic La Fe, Valencia, España.
(9) Servicio de Medicina de Aparato Digestivo, Hospital Universitario 12 de Octubre, Madrid, España.
(10) Servicio de Aparato Digestivo, Hospital Universitario Río Hortega, Valladolid, España.
(11) Servicio de Aparato Digestivo, Clínica Universitaria de Navarra, Pamplona, Navarra, España.
(12) Centre d'Atenció Primària La Florida Sud, Institut Català de la Salut, Barcelona, España.
(13) Servicio de Gastroenterología, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, España.

Magazine: Gastroenterología y Hepatología

Date: Jan 6, 2019

High Risk Digestive Tumours Prevention Consultation Unit [SP] Digestive [SP]

ABSTRACT

There is limited scientific evidence available to stratify the risk of developing metachronous colorectal cancer after resection of colonic polyps and to determine surveillance intervals and is mostly based on observational studies.

However, while awaiting further evidence, the criteria of endoscopic follow-up needs to be unified in our setting. Therefore, the Spanish Association of Gastroenterology, the Spanish Society of Family and Community Medicine, the Spanish Society of Digestive Endoscopy, and the Colorectal Cancer Screening Group of the Spanish Society of Epidemiology, have written this consensus document, which is included in chapter 10 of the "Clinical Practice Guideline for Diagnosis and Prevention of Colorectal Cancer. 2018 Update". Important developments will also be presented as regards the previous edition published in 2009.

First of all, situations that require and do not require endoscopic surveillance are established, and the need of endoscopic surveillance of individuals who do not present a special risk of metachronous colon cancer is eliminated. Secondly, endoscopic surveillance recommendations are established in individuals with serrated polyps.

Finally, unlike the previous edition, endoscopic surveillance recommendations are given in patients operated on for colorectal cancer. At the same time, it represents an advance on the European guideline for quality assurance in colorectal cancer screening, since it eliminates the division between intermediate risk group and high risk group, which means the elimination of a considerable proportion of colonoscopies of early surveillance.

Finally, clear recommendations are given on the absence of need for follow-up in the low risk group, for which the European guidelines maintained some ambiguity.

CITATION  Gastroenterol Hepatol. 2019 Jan 6. pii: S0210-5705(18)30314-5. doi: 10.1016/j.gastrohep.2018.11.001

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