ADENOMA CHARACTERISTICS AT FIRST COLONOSCOPY AS PREDICTORS OF ADENOMARECURRENCE AND CHARACTERISTICS AT FOLLOW-UP

Background & Aims: All patients with colorectal adenomas may not requi re identical follow-up. We aimed to determine if adenoma characteristi cs at initial colonoscopy could predict adenoma recurrence or characte ristics at follow-up. Methods: The number of adenomas and the size, ty pe, and degree of atypia in 479 patients in a polyp prevention trial w ere evaluated as predictors of the same characteristics at follow-up u sing odds ratios (ORs) with 95% confidence intervals (CIs). Multiple l ogistic regression analysis was performed to determine if several base line characteristics were simultaneously associated with outcome. Resu lts: Although several characteristics were significant predictors of r ecurrence univariately, by multivariate analysis, multiple adenomas at follow-up were more likely when patients had greater than or equal to 3 baseline adenomas (OR, 2.25; 95% CI, 1.20-4.21) or at least 1 tubul ovillous adenoma (OR, 2.12; 95% CI, 1.12-4.02). No specific characteri stic was associated with recurrence of high-risk polyps (greater than or equal to 1 cm, villous, severe atypia). Seventy percent of patients with 1 or 2 baseline adenomas had no recurrence, and only 3.3% had an y adenomas of clinical concern. Conclusions: Number and type of baseli ne adenomas predict recurrent adenomas, but the recurrence is rarely o f clinical concern. Patients with 1 or 2 tubular adenomas constitute a low-risk group for whom follow-up might be extended beyond 3 years.