First surveillance colonoscopy at 5 years after high-risk adenoma removal was non-inferior to 3 years

The edition in brief

In the EPoS II trial, 10,799 patients across eight European countries with high-risk adenomas removed were randomised to a first surveillance colonoscopy at 5 years or at 3 years. At an interim analysis after 5.5 years, cumulative colorectal cancer incidence was 0.77% with 5-year surveillance and 0.82% with 3-year surveillance, meeting the non-inferiority criterion; five patients died of colorectal cancer. In the RADICAL consortium, 951 patients with strictly defined immune-tolerant chronic hepatitis B were followed for a median 13 years: 51% became immune-active within five years and 72% within 15, with high-normal ALT tripling the risk, although significant fibrosis (6.3%) and HCC (1.1%) remained uncommon at 15 years. In 22,537 US veterans with alpha-1 antitrypsin genotyping, major adverse liver outcomes rose with Z-allele burden, from aHR 1.25 in PiMZ to 1.80 in PiZZ. A blinded multicentre study (published May 2026) found a multi-analyte cfDNA blood test detected 47.8% of HCC in cirrhosis against 28.3% for ultrasound, with lower specificity.