Contents
- 1 Surveillance intervals following the removal of conventional adenomas only
- 2 Surveillance intervals following the removal of serrated adenomas with or without synchronous conventional adenomas
- 3 Surveillance intervals following the removal of large sessile and laterally spreading adenomas
- 4 Surveillance intervals for second and subsequent colonoscopies
- 5 References
Surveillance intervals following the removal of conventional adenomas only
Unresolved issues
Long term outcomes following the removal of conventional adenomas are not well-described in the literature in the modern era of high quality colonoscopy. It is also unclear exactly which low risk individuals may benefit from shorter surveillance intervals. Studies of outcomes and surveillance intervals in routine endoscopy practice in Australia are lacking.
Studies currently underway
An important set of studies, the European Polyp Surveillance (EPoS) trials[1], have commenced and will be a step forward in addressing gaps in the evidence base.
Future research priorities
More prospective contemporary studies incorporating high quality colonoscopy are needed, particularly in an Australian environment. Research on the efficacy of dissemination and implementation of these guidelines along with barriers and enablers would be valuable. There is a unique opportunity with these surveillance recommendations to comprehensively assess health outcomes, colonoscopy demand and cost implications to guide the further refinement of international surveillance intervals following removal of conventional adenomas. Compulsory colonoscopy and pathology data provision to a national database would facilitate the above research priorities.
Surveillance intervals following the removal of serrated adenomas with or without synchronous conventional adenomas
Unresolved issues
The understanding of serrated adenomas in the era of modern high quality colonoscopy is evolving.
Studies currently underway
An important set of studies, the EPoS trials[1], have commenced and will be a step forward in addressing gaps in the evidence base.
Future research priorities
These guidelines are the first internationally to consider surveillance intervals of conventional and serrated adenomas alone and in combination. There is an opportunity to set up observational trials to assess outcomes to inform international surveillance intervals over time.
The resourcing implications of separate recommendations for serrated polyps are important to establish. Research on the efficacy of dissemination and implementation of these guidelines along with barriers and enablers would be valuable.
Surveillance intervals following the removal of large sessile and laterally spreading adenomas
Unresolved issues
High quality data in this area is lacking.
Studies currently underway
None
Future research priorities
Nil new
Surveillance intervals for second and subsequent colonoscopies
Unresolved issues
The understanding of serrated adenomas in the era of modern high quality colonoscopy is evolving.
Studies currently underway
None known.
Future research priorities
These guidelines are the first internationally to consider second and subsequent surveillance intervals of conventional and serrated adenomas alone and in combination. There is an opportunity to set up observational trials to assess outcomes to inform international surveillance intervals over time. The resourcing implications of these changed recommendations are important to establish. Research into the efficacy of dissemination and implementation of these guidelines along with barriers and enablers would be valuable.
References
- ↑ 1.0 1.1 Jover R, Bretthauer M, Dekker E, Holme Ø, Kaminski MF, Løberg M, et al. Rationale and design of the European Polyp Surveillance (EPoS) trials. Endoscopy 2016 Jun;48(6):571-8 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27042931.
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