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Prevalence of polyps ≥6 mm on follow-up CT colonography in a cohort with no significant colon polyps at baseline

  • Jacob Sosna
    Correspondence
    Corresponding author at: Department of Radiology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.
    Affiliations
    Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem 91120l, Israel

    Department of Radiology, Beth Israel Deaconess Medical Center, Harvard School of Medicine, Boston, MA 02215, USA

    MOR Institute for Medical Data, Bnei Brak 51377, Israel
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  • Amir Kettanie
    Affiliations
    Hebrew University-Hadassah School of Medicine, Jerusalem 91120, Israel
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  • Shifra Fraifeld
    Affiliations
    Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem 91120l, Israel
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  • Jacob Bar-Ziv
    Affiliations
    Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem 91120l, Israel

    University of Haifa, School of Public Health, Faculty of Social Welfare & Health Sciences, Haifa 34988, Israel
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  • Rafael S. Carel
    Affiliations
    MOR Institute for Medical Data, Bnei Brak 51377, Israel

    University of Haifa, School of Public Health, Faculty of Social Welfare & Health Sciences, Haifa 34988, Israel
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      Highlights

      • Prevalence of neoplasia at repeat CTC after a negative baseline exam was assessed.
      • 3 masses were detected in 3/636 participants (0.47%) at a mean 4.6-year interval.
      • 52 neoplasia ≥6 mm were found in 7.4% of participants, with/without risk factors.
      • This supports recommendations for a 5-year interval after negative baseline CTC.

      Abstract

      Aim

      Assess the prevalence of neoplasia ≥6 mm at repeat CT colonoscopy (CTC) in individuals with no significant lesions at baseline.

      Methods

      Individuals aged ≥18 years, with/without CRC risk factors, with no polyps ≥6 mm on baseline CTC (negative baseline) who underwent repeat CTC in a large HMO from 2001 to 2011 were retrospectively identified. Studies were reviewed by board-certified radiologists with experience interpreting CTC. Demographic details, CRC risk factors, and the number, size, and location of incident lesions were noted. Findings were classified using the C-RADS scale. Lesion prevalence at CTC-2 was determined, and study interval and risk characteristics of patients with- and without findings were compared.

      Results

      Our study included 636 individuals (369 men [58.0%]; mean age 59.9 years) with negative baseline CTC who underwent repeat CTC after a mean 4.6 year interval (SD 1.6 years). At baseline, 469/636 (73.7%) were at average risk for CRC; 418 remained at average risk for CTC-2 with 51 (8.0%) developing new risk factors in the interval between studies. At CTC-2, 47 participants (7.4%) presented 52 significant neoplasia: 35 polyps 6–9 mm, 14 polyps ≥10 mm, and 3 masses in 3/636 participants (0.47%). 2/3 masses, 6/14 polyps ≥10 mm (42.9%), and 12/25 polyps 6–9 mm (48.0%) were in individuals with risk factors for CRC. Histopathology was available for 12/52 lesions (23.1%): 8 tubular adenomas, 2 villous adenomas, 1 hamartomatous polyp, 1 case of normal tissue.

      Conclusion

      A mean 4.6 years after negative-baseline CTC, neoplasia ≥6 mm were seen in 7.4% of participants, including masses in 0.47%, supporting recommendations for a 5-year study interval.

      Keywords

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