腺瘤监测指南基于非粪便免疫化学测试 (FIT) 的筛查设置。然而，FIT 阳性筛查人群的结直肠癌 (CRC) 风险可能有所不同。我们根据 2010 年欧洲指南，在丹麦基于 FIT 的 CRC 筛查计划中针对中度或高风险腺瘤参与者的建议监测期内评估了 CRC 和晚期腺瘤风险。此外，我们根据欧洲胃肠内窥镜学会 (ESGE) 2020 年指南，估计了那些不建议监测的人的 CRC 风险。利用全国健康登记处，我们确定了 2014 年至 2017 年 17,936 名患有腺瘤的 FIT 筛查参与者正在接受监测（高风险）。 1 年，中度风险 3 年）。进行了后续检查的参与者被纳入其中（N = 10 068）。比较中危组和高危组之间以及根据 2020 年 ESGE 指南建议监测（S）或不监测（NS）的中间风险组之间的 CRC 和晚期腺瘤的相对风险（RR）。监测期间，CRC 发生率为 0.59%高风险组和中风险组的 1.11%（RR 0.53 [95%CI 0.34-0.84]）。高风险组患晚期腺瘤的风险增加 24%。中间NS组和中间S组的CRC发生率为1.69%和0.87%（RR 1.94 [95%CI 1.18-3.21]），晚期腺瘤的RR为1.19（95%CI 1.03-1.37）。CRC检出率较低参与者在最初的 CRC 筛查中被评为较高风险。在 FIT 阳性筛查人群中，首次筛查得出的结肠镜检查结果可能无法很好地预测 CRC 风险。Thieme。版权所有。

Adenoma surveillance guidelines are based on non-fecal immunochemical test (FIT)-based screening settings. However, colorectal cancer (CRC) risk may be different in FIT-positive screening populations. We evaluated the CRC and advanced adenoma risk within the recommended surveillance periods in the Danish FIT-based CRC screening program for participants with intermediate or high risk adenomas according to 2010 European guidelines. Furthermore, we estimated CRC risk for those who were not recommended surveillance according to European Society of Gastrointestinal Endoscopy (ESGE) 2020 guidelines.Using nationwide health registries, we identified 17 936 FIT-screening participants from 2014-2017 with adenomas undergoing surveillance (high risk 1 year, intermediate risk 3 years). Participants with a follow-up examination were included (N = 10 068). Relative risk (RR) of CRC and advance adenoma was compared between intermediate and high risk groups and between intermediates who were recommended surveillance (S) or no surveillance (NS) according to 2020 ESGE guidelines.During surveillance, CRC occurred in 0.59% of the high risk group and 1.11% of the intermediate risk group (RR 0.53 [95%CI 0.34-0.84]). The high risk group had a 24% increased risk of advanced adenoma. CRC occurred in 1.69% of the intermediateNS group and 0.87% of the intermediateS group (RR 1.94 [95%CI 1.18-3.21]), and RR for advanced adenoma was 1.19 (95%CI 1.03-1.37).CRC detection was lower among participants rated at higher risk at initial CRC screening. Findings at first screen-derived colonoscopy might not be as good a predictor of CRC risk in a FIT-positive screening population.Thieme. All rights reserved.