Two-year incidence of colon adenomas developing after tandem colonoscopy

Objectives: We attempted to determine an accurate frequency of new polyp growth in a cohort of veteran male patients who were initially cleared of polyps by tandem colonoscopy. Methods: Followup colonoscopy was performed 2 yr after tandem colonoscopy. A polyp was categorized as 'new' if it was not located in a segment of the colon or rectum that had harbored a neoplastic polyp of the same histology at tandem colonoscopy, in contradistinction to lesions designated as 'same-segment' polyps. Results: Fifty-eight of 90 patients who had tandem colonoscopy as a part of a previous study were available for follow-up colonoscopy for 2 yr. Ninety-one percent had a history of benign neoplastic polyps or cancer. Neoplastic polyps were documented in 52% (95% CI, 45-74%) of patients at followup, and 38% (95% CI, 26-52%) were found to have a total of 31 'new' lesions. All new lesions were tubular adenomas. The largest number of new polyps in an individual patient was four, and the largest new lesion was 20 mm size with a flat, linear configuration. Most (25/31) new polyps were ≤5 mm, and the number of neoplastic polyps per patient at follow-up was less than at tandem colonoscopy. Conclusions: Approximately one-half of older, male patients with a history of neoplastic polyps will demonstrate neoplastic polyps at 2 yr. In at least one-third of patients, these appear to be new lesions. In some patients, de novo neoplastic polyps can grow to ≥1 cm within 2 yr.