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Gut. 2019 Nov 27. pii: gutjnl-2019-319858. doi: 10.1136/gutjnl-2019-319858. [Epub ahead of print]

British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines.

Author information

1
Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, UK matt.rutter@nth.nhs.uk.
2
Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK.
3
Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
4
Gastroenterology, South Tyneside NHS Foundation Trust, South Shields, UK.
5
Western Sussex Hospitals NHS Foundation Trust, Chichester, UK.
6
Colorectal surgery, Raigmore Hospital, Inverness, UK.
7
Gastroenterology, Cardiff and Vale NHS Trust, Cardiff, UK.
8
Histopathology, Nottingham University Hospitals, Nottingham, UK.
9
Family History of Bowel Cancer Clinic, West Middlesex University Hospital, London, UK.
10
Imperial College, London, UK.
11
Histopathology, University College London, London, UK.
12
Centre for Medical Imaging, UCL, London, UK.
13
Endoscopy, St Marks Hospital, London, UK.
14
Wolfson Unit for Endoscopy, St Mark's Hospital, London, UK.
15
Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
16
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
17
Gastroenterology, University Hospital of Hartlepool, Hartlepool, UK.
18
London, UK.
19
Cancer Screening, Public Health England, London, UK.
20
Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine of Imperial College, Imperial College London, London, UK.
21
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.

Abstract

These consensus guidelines were jointly commissioned by the British Society of Gastroenterology (BSG), the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and Public Health England (PHE). They provide an evidence-based framework for the use of surveillance colonoscopy and non-colonoscopic colorectal imaging in people aged 18 years and over. They are the first guidelines that take into account the introduction of national bowel cancer screening. For the first time, they also incorporate surveillance of patients following resection of either adenomatous or serrated polyps and also post-colorectal cancer resection. They are primarily aimed at healthcare professionals, and aim to address:Which patients should commence surveillance post-polypectomy and post-cancer resection?What is the appropriate surveillance interval?When can surveillance be stopped?two or more premalignant polyps including at least one advanced colorectal polyp (defined as a serrated polyp of at least 10 mm in size or containing any grade of dysplasia, or an adenoma of at least 10 mm in size or containing high-grade dysplasia); orfive or more premalignant polypsThe Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument provided a methodological framework for the guidelines. The BSG's guideline development process was used, which is National Institute for Health and Care Excellence (NICE) compliant.two or more premalignant polyps including at least one advanced colorectal polyp (defined as a serrated polyp of at least 10 mm in size or containing any grade of dysplasia, or an adenoma of at least 10 mm in size or containing high-grade dysplasia); orfive or more premalignant polypsThe key recommendations are that the high-risk criteria for future colorectal cancer (CRC) following polypectomy comprise either:two or more premalignant polyps including at least one advanced colorectal polyp (defined as a serrated polyp of at least 10 mm in size or containing any grade of dysplasia, or an adenoma of at least 10 mm in size or containing high-grade dysplasia); orfive or more premalignant polypsThis cohort should undergo a one-off surveillance colonoscopy at 3 years. Post-CRC resection patients should undergo a 1 year clearance colonoscopy, then a surveillance colonoscopy after 3 more years.

KEYWORDS:

colonic polyps; colonoscopy; colorectal adenomas; colorectal cancer; surveillance

PMID:
31776230
DOI:
10.1136/gutjnl-2019-319858
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Conflict of interest statement

Competing interests: JE – Clinical advisory boards: Lumendi, Boston Scientific; Speaker fees: Olympus, FalkColin Rees – Research grant: ARC medical, Norgine, Olympus. Expert witness: ARC medical Matt Rutter – Speaker fees: SwissSCWeb, Pentax; Research Grant: Olympus; Consultancy: Norgine DJMT – Speaker fees: Bracco, Guerbet.

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