Imperial College London
Paul Greliak

Paul Greliak

Faculty of Medicine, Department of Surgery & Cancer

Clinical Trial Manager
 
 
 
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Contact

 

p.greliak

 
 
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Location

 

1089Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Atkin:2017:10.1016/S1470-2045(17)30187-0,
author = {Atkin, WS and Wooldrage, K and Brenner, A and Martin, J and Shah, U and Perera, S and Lucas, F and Brown, JP and Kralj-Hans, I and Greliak, P and Pack, K and Wood, J and Thomson, A and Veitch, A and Duffy, SW and Cross, AJ},
doi = {10.1016/S1470-2045(17)30187-0},
journal = {Lancet Oncology},
pages = {823--834},
title = {Adenoma surveillance on colorectal cancer incidence: a retrospective, multicentre, cohort study},
url = {http://dx.doi.org/10.1016/S1470-2045(17)30187-0},
volume = {18},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundRemoval of adenomas reduces colorectal cancer incidence and mortality; however, the benefit of surveillance colonoscopy on colorectal cancer risk remains unclear. We examined heterogeneity in colorectal cancer incidence in intermediate-risk patients and the effect of surveillance on colorectal cancer incidence.MethodsWe did this retrospective, multicentre, cohort study using routine lower gastrointestinal endoscopy and pathology data from patients who, after baseline colonoscopy and polypectomy, were diagnosed with intermediate-risk adenomas mostly (>99%) between Jan 1, 1990, and Dec 31, 2010, at 17 hospitals in the UK. These patients are currently offered surveillance colonoscopy at intervals of 3 years. Patients were followed up through to Dec 31, 2014.We assessed the effect of surveillance on colorectal cancer incidence using Cox regression with adjustment for patient, procedural, and polyp characteristics. We defined lower-risk and higher-risk subgroups on the basis of polyp and procedural characteristics identified as colorectal cancer risk factors. We estimated colorectal cancer incidence and standardised incidence ratios (SIRs) using as standard the general population of England in 2007. This trial is registered, number ISRCTN15213649.Findings253798 patients who underwent colonic endoscopy were identified, of whom 11944 with intermediate-risk adenomas were included in this analysis. After a median follow-up of 7·9 years (IQR 5·6–11·1), 210 colorectal cancers were diagnosed. 5019 (42%) patients did not attend surveillance and 6925 (58%) attended one or more surveillance visits. Compared to no surveillance, one or two surveillance visits were associated with a significant reduction in colorectal cancer incidence rate (adjusted hazard ratio 0·57, 95% CI 0·40–0·80 for one visit; 0·51, 0·31–0·84 for two visits). Without surveillance, colorectal cancer incidence in patie
AU  - Atkin,WS
AU  - Wooldrage,K
AU  - Brenner,A
AU  - Martin,J
AU  - Shah,U
AU  - Perera,S
AU  - Lucas,F
AU  - Brown,JP
AU  - Kralj-Hans,I
AU  - Greliak,P
AU  - Pack,K
AU  - Wood,J
AU  - Thomson,A
AU  - Veitch,A
AU  - Duffy,SW
AU  - Cross,AJ
DO  - 10.1016/S1470-2045(17)30187-0
EP  - 834
PY  - 2017///
SN  - 1474-5488
SP  - 823
TI  - Adenoma surveillance on colorectal cancer incidence: a retrospective, multicentre, cohort study
T2  - Lancet Oncology
UR  - http://dx.doi.org/10.1016/S1470-2045(17)30187-0
UR  - http://hdl.handle.net/10044/1/45420
VL  - 18
ER  -
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