One of the most dreaded complications is high-grade dysplasia (HGD) and colorectal cancer (CRC), together advanced neoplasia (AN). Optimal prediction, detection and management of AN are essential due to the morbidity and mortality of AN. This thesis shows that bacterial markers in feces may improve prediction of AN. In addition, we demonstrate that compliance with endoscopic quality indicators is essential for effective prevention of AN. We observed that patients’ preferences were most strongly influenced by bowel preparation type and not CRC risk reduction or surveillance interval. We showed that revision and expert pathologist consensus is essential for accurate HGD diagnoses. Lastly, we observed that endoscopic resection of AN results in an increased risk of recurring neoplasia compared to a surgical removal of the entire large intestine. By contrast, partial colectomy, in which a part of the large intestine is left in place, does not show an increased risk.
Maarten te Groen (1993) obtained his Master’s degree in Medicine, cum laude, at the Radboud University, after which he worked as a junior doctor in Gastroenterology in the Canisius-Wilhelmina hospital and Radboudumc. In 2019 he started with his PhD at the Gastroenterology department of the Radboudumc. From April 2023 onwards, he will start as a resident in Gastroenterology and Hepatology in the Rijnstate hospital, Arnhem.