Clinical outcomes were collected for all patients who provided a viable sample, by requesting copies of examination reports from participating sites every month. All diagnoses were determined by reviewing endoscopy, radiology, and histology reports, clinic letters, and urgent referral forms provided by the participating sites. Patient and clinical data included symptoms, reasons for the referral, medical history, and sociodemographic factors. All diagnoses were verified by medical members of the central research team.
All neoplastic bowel polyps, either adenomatous polyps or sessile serrated polyps, were identified and were given a risk of either ‘low’, ‘intermediate’, or ‘high’ depending on their size and frequency; contemporary UK and European guidelines were used in this study23 ,24 (link), with low risk defined as 1–2 adenomas less than 10 mm, intermediate risk as 3–4 small adenomas less than 10 mm or one adenoma 10 mm or more, and high risk as five or more adenomas less than 10 mm or three or more adenomas with at least one 10 mm or more.
Non-neoplastic polyps, such as hyperplastic, inflammatory, or pseudopolyps, were classified separately. Patients with a risk score for their polyps at first, second, or third examinations had their cumulative number and/or highest risk polyp taken as their final score. Remaining bowel pathology was classified as one of CRC, inflammatory bowel disease (colitis/proctitis), diverticulosis, haemorrhoids, normal examination, or procedure stopped/incomplete. Patients with concurrent polyps and CRC were classified as CRC and not included in the analysis, as our target group for this study was those without CRC in whom we could potentially identify polyps and plan for removal before they could progress to CRC.
All neoplastic bowel polyps, either adenomatous polyps or sessile serrated polyps, were identified and were given a risk of either ‘low’, ‘intermediate’, or ‘high’ depending on their size and frequency; contemporary UK and European guidelines were used in this study23 ,24 (link), with low risk defined as 1–2 adenomas less than 10 mm, intermediate risk as 3–4 small adenomas less than 10 mm or one adenoma 10 mm or more, and high risk as five or more adenomas less than 10 mm or three or more adenomas with at least one 10 mm or more.
Non-neoplastic polyps, such as hyperplastic, inflammatory, or pseudopolyps, were classified separately. Patients with a risk score for their polyps at first, second, or third examinations had their cumulative number and/or highest risk polyp taken as their final score. Remaining bowel pathology was classified as one of CRC, inflammatory bowel disease (colitis/proctitis), diverticulosis, haemorrhoids, normal examination, or procedure stopped/incomplete. Patients with concurrent polyps and CRC were classified as CRC and not included in the analysis, as our target group for this study was those without CRC in whom we could potentially identify polyps and plan for removal before they could progress to CRC.
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