Joseph D. Feuerstein, MD; Daniel A. Leffler, MD, MS
Potential Conflicts of Interest: Dr. Leffler: Consultancy and grants/grants pending: Prometheus Diagnostics, Alba Pharmaceuticals, Alvine Therapeutics, Shire Therapeutics.
Feuerstein J., Leffler D.; Colonoscopy and Polyp Characteristics. Ann Intern Med. 2013;158:141-142. doi: 10.7326/0003-4819-158-2-201301150-00023
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Published: Ann Intern Med. 2013;158(2):141-142.
TO THE EDITOR:
We read Brenner and colleagues' article (1) with interest. The authors report that risk factors for colon cancer in the control group were incomplete polyp removal, detection of 3 or more polyps, and no surveillance colonoscopy in the past 5 years. In addition, incomplete colonoscopy, defined as failure to intubate the cecum, occurred in 7.7% of the control group. These findings are consistent with the accepted standard quality metrics in the United States for an adequate screening colonoscopy program (2).
Brenner and colleagues' findings contrast with those of Kaminski and associates (3). In the 188 788 person-years of Kaminski and coworkers' study, 92.9% of cases of interval colorectal cancer developed in patients who had no previous adenomas and 83.3% had no family history. Only 1 participant's interval colorectal cancer was attributed to ineffective polypectomy. However, ineffective polypectomy has been associated with 19% to 27% of cases of interval cancer because of remaining adenomatous tissue (2).
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