Total Number of Polyps are Associated with an Increased Risk of Recurrent Adenomatous Polyps

1.1. Background Current guidelines on interval between surveillance colonoscopy is limited by insufficient understanding about the rate of polyp re-growth. 1.2. Aim To determine the prevalence and predictors of recurrent adenomas and advanced adenomas (AAs) in individuals with high-risk adenomas (defined as having one polyp>10 mm in size, >3 polyps or one AA). 1.3. Method One-hundred-and-sixty-eight patients with high-risk adenomas at index colonoscopy were recruited into this study. All patients underwent a second colonoscopy 3 months later to ensure clearance of all polyps. Further colonoscopies were performed at 12, 24 and 36 months after index colonoscopy. 1.4. Results At 36 months, 91 of the 168 patients (54.2%) had recurrent adenomas. The cumulative probability of recurrent adenomas at 12, 24 and 36 months were 19.0%, 47.0% and 54.2%. On multivariate analysis, total number of adenomas and sessile serrated lesions at index colonoscopy was the only independent factor associated with recurrent adenomas [RR 1.066, 95% CI 1.004-1.095; p= 0.034]. Twelve of the 168 patients (7.1%) had recurrent AAs at 36 months. The cumulative probability of recurrent AAs at 12, 24 and 36 months were 1.2%, 4.8% and 7.1%. Total number of adenomas and sessile serrated lesions at index colonoscopy was the only independent factor associated recurrent AAs [RR 1.145, 95% CI 1.043-1.257; p= 0.004].