Appropriateness of colonoscopy in Europe (EPAGE II) : surveillance after polypectomy and after resection of colorectal cancer
JournalItem (Reviews, Editorials, Rezensionen, Urteilsanmerkungen etc. in einer wissenschaftlichen Zeitschrift)
ID 1197516
Author(s) Arditi, C; Gonvers, J-J; Burnand, B; Minoli, G; Oertli, D; Lacaine, F; Dubois, R W; Vader, J-P; Schusselé Filliettaz, S; Peytremann-Bridevaux, I; Pittet, V; Juillerat, P; Froehlich, F; EPAGE II Study Group
Author(s) at UniBasel Oertli, Daniel
Froehlich, Florian
Year 2009
Title Appropriateness of colonoscopy in Europe (EPAGE II) : surveillance after polypectomy and after resection of colorectal cancer
Journal Endoscopy
Volume 41
Number 3
Pages 209-17
Abstract BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for surveillance after polypectomy and after curative-intent resection of colorectal cancer (CRC), and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews and primary studies regarding the evaluation and management of surveillance colonoscopy after polypectomy and after resection of CRC was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: Most CRCs arise from adenomatous polyps. The characteristics of removed polyps, especially the distinction between low-risk adenomas (1 or 2, small [< 1 cm], tubular, no high-grade dysplasia) vs. high-risk adenomas (large [> or = 1 cm], multiple [> 3], high-grade dysplasia or villous features), have an impact on advanced adenoma recurrence. Most guidelines recommend a 3-year follow-up colonoscopy for high-risk adenomas and a 5-year colonoscopy for low-risk adenomas. Despite the lack of evidence to support or refute any survival benefit for follow-up colonoscopy after curative-intent CRC resection, surveillance colonoscopy is recommended by most guidelines. The timing of the first surveillance colonoscopy differs. The expert panel considered that 56 % of the clinical indications for colonoscopy for surveillance after polypectomy were appropriate. For surveillance after CRC resection, it considered colonoscopy appropriate 1 year after resection. CONCLUSIONS: Colonoscopy is recommended as a first-choice procedure for surveillance after polypectomy by all published guidelines and by the EPAGE II criteria. Despite the limitations of the published studies, colonoscopy is also recommended by most of the guidelines and by EPAGE II criteria for surveillance after curative-intent CRC resection.
Publisher Georg Thieme
ISSN/ISBN 0013-726X
Full Text on edoc No
Digital Object Identifier DOI 10.1055/s-0028-1119646
PubMed ID
ISI-Number WOS:000264658400004
Document type (ISI) Journal Article, Review

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