RecruitingNot ApplicableNCT05355363

Risk of Metachronous Findings After Detection of Serrated Lesions and High-grade Dysplasia With Surveillance Delay

Sponsor

Centre hospitalier de l'Université de Montréal (CHUM)

Enrollment

730 participants

Start Date

Feb 27, 2023

Study Type

INTERVENTIONAL

Conditions

Colorectal, Cancer Colon Adenoma

Summary

The primary aim of this study is to determine the rate of total metachronous advanced neoplasia (TMAN) detection after index detection of serrated lesions (SL) \[sessile serrated polyps (SSPs), traditional serrated adenomas (TSAs)\], and metachronous high-risk adenoma (HRA) after index detection of high-grade dysplasia (HGD). We will use the database of patients diagnosed with SL or HGD at index colonoscopy with a delay in surveillance and determine the risk of advanced lesions (especially high-risk lesion and CRC detection) of these delayed colonoscopies. The aim is to determine the effects of breach of continuity of care in these patients.

Eligibility

Min Age: 45 YearsMax Age: 80 Years

Inclusion Criteria1

Patients 45-80 who underwent colonoscopy from 2009 to 2022 at the Montreal University Hospital Center (CHUM) with 1+ SL or HGD detected at index colonoscopy and lacking follow-up within or beyond the surveillance interval recommended by 2020 USMSTF guidelines.

Exclusion Criteria6

\) Patients with a diagnosis of inflammatory bowel disease;
\) Hereditary CRC syndromes;
\) CRC at index colonoscopy;
\) Serrated polyposis syndrome;
\) Life expectancy too short to benefit from colonoscopy;
\) Follow-up colonoscopy not yet due according to USMSTF guidelines. Patients with concomitant HRA and SL at index will be invited to participate if the index (or last) colonoscopy was performed more than 1 year ago. This is based on the high rates of HRA we identified in our retrospective study posing increased risks for these patients.

Interventions

DIAGNOSTIC_TESTStandard Colonoscopy

Standard colonoscopy: All optically diagnosed polyps will be removed and sent to the CHUM pathology laboratory for histopathological evaluation according to institutional standards.