THE FUNEN ADENOMA FOLLOW-UP-STUDY - INCIDENCE AND DEATH FROM COLORECTAL-CARCINOMA IN AN ADENOMA SURVEILLANCE PROGRAM

The results of a prospective randomized study of 1056 patients with co lorectal adenomas are presented. After initial polypectomy from 1978 t o 1992, patients were allocated at random to different follow-up inter vals varying from 6 to 48 months, except 53 patients who were allocate d to intervals of 6 months. The examinations were mainly done by colon oscopy. Ten patients developed colorectal carcinoma, a number similar to that expected (7.96), when compared with a sex- and age-matched nor mal Danish population. The expected number of carcinomas was also calc ulated from adenoma to carcinoma conversion rates estimated in other s tudies and compared with that observed. If all carcinomas develop in l arge (greater-than-or-equal-to 10 mm) adenomas or adenomas with severe dysplasia, the expected number of carcinomas would have been 62 and 1 10, respectively, indicating a significant reduction of carcinomas in the present study. One patient died of colorectal carcinoma, which is significantly lower than the number expected (7.58). Two patients die d of complications from therapeutic and diagnostic colonoscopy-that is , 2 deaths in 3959 colonoscopies. In conclusion, the follow-up strateg y has resulted in a mortality from colorectal carcinoma which is reduc ed when compared with the normal population, in spite of an apparently similar incidence of carcinoma. However, previous suggested adenoma-c arcinoma conversion rates indicate that a major reduction of incidence actually has taken place.