Table of Contents
ISRN Gastroenterology
Volume 2014, Article ID 261302, 4 pages
Research Article

Development of Polyps and Cancer in Patients with a Negative Colonoscopy: A Follow-Up Study of More Than 20 Years

Department of Internal Medicine and Gastroenterology, Zaans Medisch Centrum, Postbus 210 1500 EE Zaandam, The Netherlands

Received 30 December 2013; Accepted 22 January 2014; Published 4 March 2014

Academic Editors: F. A. Macrae and S. Ogino

Copyright © 2014 R. J. L. F. Loffeld. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Adenomas are missed during colonoscopy. Aim. Assess the occurrence of colorectal cancer (CRC) and polyps in patients with a negative index colonoscopy (IC). Patients and Methods. All patients with a IC in 1992–1994, aged 40 and 60 years, were included. Exclusion criterion was presence of abnormalities, a family history, or surveillance. At the end of 2013 all records were studied in order to gather follow-up information. Results. 394 patients were included in four groups: group 1 patients who died, group 2 patients who were not in the hospital systems anymore, group 3 patients still visiting the hospital but not the department of gastroenterology, and group 4 patients undergoing new colonoscopies. In group 1, 2 patients died of CRC and 4 developed a polyp. No data were available from the patients in group 2. Patients in group 3 visited the outpatient clinics but did not undergo new colonoscopy. Patients in group 4 underwent additional colonoscopies. The yield was 35 patients polyps and three CRCs. Five patients (1.3%) developed CRC, and 39 (9%) developed a polyp. Conclusion. Given these results the number of potentially missed adenomas in IC is very low and the consequences of missed adenomas are highly exaggerated.