Morphology, Anatomic Distribution and Cancer Potential of Colonic Polyps

Shinya, Hiromi; Wolff, William I.

doi:10.1097/00000658-197912000-00001

Cited by 482 publications

(185 citation statements)

References 6 publications

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“…Our results are consistent with much of the previously published literature [3][4][5][6][7][8][9][10][11][12][13][14][15][20][21][22][23][24][25][26][27] , particularly reports from the last 10 years ( Table 2). As noted earlier, the trends toward decreasing prevalence rates of cancer in small and diminutive polyps may reflect the improved imaging capabilities of colonoscopes, and increasing emphasis on identification of flat lesions which do not increase the risk of cancer compared to polypoid lesions [16][17][18] .…”

supporting

confidence: 93%

“…Further the fraction of polyps ≤ 5 mm and 6-9 mm in size was comparable to or higher than prior studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][22][23][24][25][26][27][28][29] . Any underestimation of polyp size would tend to cause the apparent prevalence of cancer in polyps of different size ranges to increase.…”

supporting

confidence: 79%

“…The overall distribution of polyp sizes in this study suggests that the tendency of endoscopists in our unit is to underestimate polyp size, particularly since the percentage of all polyps < 1 cm in size was comparable to other studies [3][4][5][6][7][8][9][10][11][12][13][14][15][21][22][23][24][25][26][27] , despite our center receiving many referrals for large and complex polypectomies 28 . Further the fraction of polyps ≤ 5 mm and 6-9 mm in size was comparable to or higher than prior studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][22][23][24][25][26][27][28][29] .…”

supporting

confidence: 78%

“…Early studies of cancer prevalence in small and diminutive polyps found a substantial cancer risk, which exceeded 0.4% in polyps 6 to 9 mm in size in some studies [3][4][5][6][7] . However, more recent colonoscopic studies found a much lower prevalence [8][9][10][11][12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

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Risk of cancer in small and diminutive colorectal polyps

Ponugoti

Cummings

Rex

2017

Digestive and Liver Disease

119

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The prevalence of cancer in small and diminutive polyps is relevant to "resect and discard" and CT colonography reporting recommendations.We evaluated a prospectively collected colonoscopy polyp database to identify polyps < 10 mm and those with cancer or advanced histology (high-grade dysplasia or villous elements)Of 32,790 colonoscopies, 15,558 colonoscopies detected 42,630 polyps < 10 mm in size. A total of 4,790 lesions were excluded as they were not conventional adenomas or serrated class lesions.There were 23,524 conventional adenomas < 10 mm of which 22,952 were tubular adenomas.There were 14,316 serrated class lesions of which 13,589 were hyperplastic polyps and the remainder were sessile serrated polyps. Of all conventional adenomas, 96 had high-grade dysplasia including 0.3% of adenomas ≤ 5 mm in size and 0.8% of adenomas 6-9 mm in size. Of all conventional adenomas, 2.1% of those ≤ 5 mm in size and 5.6% of those 6-9 mm in size were advanced. Among 36,107 polyps ≤ 5 mm in size and 6,523 polyps 6-9 mm in size, there were no cancers.These results support the safety of resect and discard as well as current CT colonography reporting recommendations for small and diminutive polyps.

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supporting

confidence: 93%

supporting

confidence: 79%

supporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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Risk of cancer in small and diminutive colorectal polyps

Ponugoti

Cummings

Rex

2017

Digestive and Liver Disease

119

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“…It is estimated that only 5% of all adenomas actually progress to malignancy [5] and that this process generally takes many years. Theoretically, the removal of this 5% of adenomas would be sufficient to prevent colorectal cancer, but unfortunately it is hard to identify this subgroup.…”

Section: Introductionmentioning

confidence: 99%

The adenoma hunt in colorectal cancer screening: defining the target

Sillars-Hardebol

Carvalho

Engeland

et al. 2011

The Journal of Pathology

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Colorectal adenomas are precursor lesions of colorectal cancer. Different biological and metabolic processes contribute to adenomagenesis. Subsequent progression to carcinoma occurs in only about 5% of the cases. Detection and removal of all adenomas would reduce CRC incidence and mortality, but at the cost of major over-treatment. Classical morphological characteristics fail to accurately discriminate between adenomas that will become malignant and those that will not. Understanding the biology of cancer development will help to better characterize adenomas at high risk of progression, and subsequently establish triage tests that allow to safely reserve colonoscopy only for individuals at high probability of having truly high-risk colorectal adenomas. Screening tests based on genomic changes that affect relevant biological and metabolic processes hold most promise in this respect.

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A Second Look at Colonoscopy

Abrams¹

1982

Arch Surg

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Morphology, Anatomic Distribution and Cancer Potential of Colonic Polyps

Cited by 482 publications

References 6 publications

Risk of cancer in small and diminutive colorectal polyps

Risk of cancer in small and diminutive colorectal polyps

The adenoma hunt in colorectal cancer screening: defining the target

A Second Look at Colonoscopy

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