MEDICATIONS: COLON POLYP RECURRENCE IS HIGH AFTER TREATMENT

February 25, 2003 — The risk of colon polyp recurrence is high even among patients who get screened and treated, according to an article in the February 24 issue of The Archives of Internal Medicine, a journal of the American Medical Association.

Colorectal cancers are the third most common cancers in men and women, with an estimated 135,400 new cases and 56,700 deaths in 2001, according to information provided in the article. Polyps (small growths on the colon or rectum) have been identified as precursors to colorectal cancer, and early identification and removal of polyps is routine for the prevention of cancer. However, the risk of colon cancer persists even with polypectomy (surgical removal of polyps). Approximately 37 percent to 60 percent of patients re-screened for polyps after polypectomy are found to have more polyps.

Marianne Ulcickas Yood, D.Sc., M.P.H., of Galt Associates, Sterling, Va., and colleagues determined the risk and the length of time between polypectomy and the return of polyps in 8,865 patients who were part of a large health maintenance organization (HMO) where colon cancer screening was a covered benefit. The participants were 50 years old or older and underwent a polypectomy between January 1, 1989, and December 31, 1999. Patients were followed up through September 1, 2001.

Of the 8,865 patients who underwent polypectomy, 2,704 patients (30.5 percent) were diagnosed as having recurrent polyps. After analysis, the researchers projected that an estimated 50 percent of patients will have a recurrence within 7.6 years. Among patients who underwent colon screening at least 9 months after their polypectomy (52 percent of the study group), the authors' analysis suggested that 50 percent would have a recurrent polyp within 3.9 years.

"Efforts to increase and monitor ongoing screening of postpolypectomy patients and efforts to improve appropriate colorectal cancer screening activities are warranted," write the authors. "In addition, further research is needed to better identify patients at risk for recurrence so that continued screening and other interventions can be targeted at these groups."

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