Prevalence of Clinically Important Histology in Small Adenomas

Butterly, Lynn F.; Chase, Michael P.; Pohl, Heiko; Fiarman, Gale S.

doi:10.1016/j.cgh.2005.12.021

Cited by 249 publications

(124 citation statements)

References 29 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: 92%

“…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: 79%

“…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: 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: 92%

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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“…The risk of malignancy was described in all adenomas, depending on their size: 1% of malignancy is seen in polyps 5-10 mm of size and several percent in polyps larger than 10 mm [2].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of colonic adenomas in patients with metabolic syndrome

Gajecki¹,

Kempiński²,

Poniewierka³

2012

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Introduction: Seventy percent of colonic polyps are adenomas -benign neoplastic tissue deriving from epithelium with various grades of dysplasia. Metabolic syndrome is discussed as one of the risk factors for development of colonic adenomas. Aim: To evaluate the relation between metabolic syndrome and prevalence of colonic polyps. Material and methods: In 2008-2011, 151 patients (aged 50-70 years) from the city of Strzegom were enrolled in a prophylactic programme. Each patient had the following examinations performed: physical examination, abdomen ultrasound, chest X-ray, oesophagogastroduodenoscopy, colonoscopy, ECG and laboratory tests. In females mammography and gynaecological examination were performed, and in males prostate-specific antigen (PSA) level was evaluated. Results: The prevalence of adenomas was higher in patients with metabolic syndrome (33.3% vs. 20.6%, p < 0.05). Also higher prevalence of adenomas larger than 10 mm was found in patients with metabolic syndrome. HDL level above 95 mg% and HDL level 45-95 mg% with fulfilled criteria of metabolic syndrome were determined as risk factors of colonic adenoma development. Conclusions: Metabolic syndrome can be a risk factor for development of colonic adenomas. Adenoma growth can be accelerated in metabolic syndrome. HDL molecules can promote colonic proliferation and formation of adenomas.

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