Topic:	digestive diseases (dd)
Title:	New Post-Polypectomy Surveillance Guidelines.
Author:	Winawer, S.J.
Source:	Practical Gastroenterology. 31(8): 30, 35-42. August 2007.
Abstract:	People found to have adenomatous polyps usually undergo polypectomy and then are placed into a surveillance program of periodic colonoscopy to remove missed synchronous and new metachronous adenomas and cancers. This article reviews new postpolypectomy surveillance guidelines issued by the United States Multi-Society Task Force on Colorectal Cancer and the American Cancer Society (USM-STF/ACS). The author outlines how this set of guidelines differs from earlier guidelines: They offer a consensus statement that strengthens the guidelines, they specifically examine predictors of advanced adenomas and incorporate them into the guidelines, and they emphasize the quality of baseline colonoscopy and its impact on detection of postpolypectomy colorectal cancer. The author maintains that risk stratification can reduce the intensity of follow-up evaluation in a substantial proportion of these patients, so limited colonoscopy resources could be shifted from surveillance to screening and diagnosis. The article includes the recommendations, addition surveillance considerations, and a discussion of their implications for clinical practice. 8 tables. 67 references.
Format:	Journal Article
Language:	English.
Major Keywords:	Digestive System Diseases. Colon Cancer. Colorectal Diseases. Polyps. Colonoscopy. Follow Up of Treatment. Patient Selection. Guidelines.
Minor Keywords:	Postoperative Care. Postoperative Complications. Patient Care Management. Risk Factors. Screening. Diagnosis. Diagnostic Tests.
Publication Number:	DDJA12978.
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