Forty-Year Analysis of Colonoscopic Surveillance Program for XXXX : An Updated Overview.

@entity1 @entity31 @entity1141 @entity14
OBJECTIVES: This study provides an overview of the largest and longest-running colonoscopic surveillance program for @entity14 ( @entity14 ) in @entity1 with long-standing @entity31 ( @entity31 ). METHODS: Data were obtained from medical records, endoscopy, and histology reports. Primary end points were defined as death, colectomy, withdrawal from surveillance, or censor date (1 January 2013). RESULTS: A total of 1,375 @entity31 @entity1 were followed up for 15,234 @entity1 -years (median, 11 years per @entity1 ). @entity14 was detected in 72 @entity1 (incidence rate (IR), 4.7 per 1,000 @entity1 -years). Time-trend analysis revealed that although there was significant decrease in incidence of colectomy performed for @entity1141 (linear regression, R=-0.43; P=0.007), IR of advanced @entity14 and interval @entity14 have steadily decreased over past four decades (Pearson's correlation, -0.99; P=0.01 for both trends). The IR of early @entity14 has increased 2.5-fold in the current decade compared with past decade (  (2), P=0.045); however, its 10-year survival rate was high (79.6%). The IR of @entity1141 has similarly increased (  (2), P=0.01), potentially attributable to the recent use of chromoendoscopy that was twice more effective at detecting @entity1141 compared with white-light endoscopy (  (2), P<0.001). CRCs were frequently accompanied by @entity14 or spatially distinct @entity1141 (37.5%). Finally, the risk of @entity14 was not significantly different between "indefinite" or low-grade @entity1141 (log-rank, P=0.78). CONCLUSIONS: Colonoscopic surveillance may have a significant role in reducing the risk of advanced and interval @entity14 while allowing more @entity1 to retain their colon for longer. Given the ongoing risk of early @entity14 , @entity1 with any grade of @entity1141 who are managed endoscopically should be monitored closely with advanced techniques.
