Prevalence of flat lesions in a large screening population and their role in colonoscopy quality improvement

Reinhart, K; Bannert, Christina; Dunkler, Daniela; Salzl, Petra; Trauner, Michael; Renner, Fritz; Knoflach, P; Ferlitsch, Arnulf; Weiss, Werner; Ferlitsch, Monika

doi:10.1055/s-0032-1326348

Cited by 43 publications

(30 citation statements)

References 28 publications

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“…A greater malignant potential for lesions >10 mm (P<0.0001) was observed by Reinhart et al (23) , regardless of morphology. However, there have been series showing that small, non-polypoid lesions are more likely to contain carcinoma and a deeper infiltration of the submucosa, when compared to larger, polypoid lesions (14,20,29) .…”

Section: Discussionmentioning

confidence: 55%

Malignancy in Large Colorectal Lesions

Santos

Malaman

Carvalho

et al. 2014

Arq. Gastroenterol.

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-Context -The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion. Objective -To evaluate the malignancy of colorectal lesions >20 mm. Methods -Between 2007 and 2011, 76 neoplasms >20 mm in 70 patients were analyzed. Results -The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm + 6.2 mm (range: 20 to 50 mm). Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3%) lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5%) and IV (53.9%) pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma), with no difference in morphology and site. Only one lesion (1.3%) invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001). The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%. Conclusions -Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions. HEADINGS -Colonic polyps. Colorectal neoplasms. Gastrointestinal endoscopy.

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Section: Discussionmentioning

confidence: 55%

Malignancy in Large Colorectal Lesions

Santos

Malaman

Carvalho

et al. 2014

Arq. Gastroenterol.

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“…Details about this project were reported elsewhere (Ferlitsch et al , 2011; Bannert et al , 2012; Reinhart et al , 2013; Kozbial et al , 2014; Waldmann et al , 2015). All colonoscopy data of this study performed between November 2008 and December 2012 were assessed within this project, and comprised 80 931 colonoscopies performed in 80 398 persons.…”

Section: Methodsmentioning

confidence: 99%

Risk factors cannot explain the higher prevalence rates of precancerous colorectal lesions in men

et al. 2016

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“…In women and men older than 80 years, the rates increased to 27% and 40%, respectively [1]. A recent population-based study found that at least one polyp was detected in 34.3% of asymptomatic patients undergoing a screening colonoscopy [2]. In autopsy series, the prevalence is even higher and increases with age.…”

Section: Neoplastic Colorectal Polypsmentioning

confidence: 99%

Colorectal polyps and polyposis syndromes

Shussman

Wexner

2014

Gastroenterology Report

163

122

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A polyp is defined as any mass protruding into the lumen of a hollow viscus. Colorectal polyps may be classified by their macroscopic appearance as sessile (flat, arising directly from the mucosal layer) or pedunculated (extending from the mucosa through a fibrovascular stalk). Colorectal polyps may also be histologically classified as neoplastic or as non-neoplastic (hyperplastic, hamartomatous, or inflammatory). The neoplastic polyps are of primary importance because they harbor a malignant potential, which represents a stage in the development of colorectal cancer. For this reason, it is essential to identify these polyps at a sufficiently early stage, when a simple outpatient procedure to remove them can interrupt the development of colorectal cancer and prevent disease and death. When invasive carcinoma arises in a polyp, careful consideration must be given to ensuring the adequacy of treatment. Although most neoplastic polyps do not evolve into cancer, it is well accepted that the majority of colorectal carcinomas evolve from adenomatous polyps; the sequence of events leading to this transformation is referred to as the adenoma-to-carcinoma sequence.The presence of a systemic process that promotes the development of multiple gastro-intestinal polyps is termed ‘polyposis’. Hereditary gastro-intestinal polyposis syndromes account for approximately 1% of all cases of colorectal cancer and are associated with a broad spectrum of extra-colonic tumors. Early detection and accurate classification of these syndromes are essential, in order to initiate a surveillance program for the early detection of cancer. Several polyposis syndromes have been described, each having its own genetic basis and characteristic polyp distribution, clinical presentation, and malignancy risk.Diagnostic modalities and treatment options for neoplastic polyps—as well as the most prevalent polyposis syndromes—are reviewed below.

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Prevalence of flat lesions in a large screening population and their role in colonoscopy quality improvement

Abstract: Malignant potential of polyps is mostly affected by size but not by shape. Since flat polyp detection rate only correlates poorly with ADR we do not recommend its incorporation in quality assured screening colonoscopy.

Cited by 43 publications

References 28 publications

Malignancy in Large Colorectal Lesions

Malignancy in Large Colorectal Lesions

Risk factors cannot explain the higher prevalence rates of precancerous colorectal lesions in men

Colorectal polyps and polyposis syndromes

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