Prevalence of polyps in an autopsy series from areas with varying incidence of large‐bowel cancer

Abstract

The results of this multicentre autopsy study emphasize the relationship between the prevalence of adenomas and the incidence of large-bowel cancer. The highest proportion of autopsies with adenomas was observed in the area with the highest incidence of large-bowel cancer. The segmental distribution of adenomas within the colon was found to be similar to the site distribution of cancer. However, the lowest proportion of adenomas was found in the rectum, the segment in which cancer is most frequent. The latter finding suggests that either the adenoma-carcinoma sequence is a less important pathway in the pathogenesis of rectal cancer, or that more rectal than colonic adenomas become malignant. The high proportion of hyperplastic polyps in the rectum, and statistically significant regional differences following the same patterns as the incidence of rectal cancer suggest that there could be at least an indirect relationship between hyperplastic polyps and cancer of the rectum. Adenomas of both colon and rectum were more frequent in men than in women, contrary to findings with colon cancer. However, as for colon cancer, the sex ratio of adenomas changed with age, from slightly below unity in persons under 65, to above unity for those aged 65 and over. A major difficulty that emerged was the histological identification of "polyps" because of the degree of autolysis of epithelial cells in the mucous membrane, and this difficulty largely contributed to the poor consistency of histological reporting. Regular consistency surveys of histological preparations should be recommended in any type of multicentre study in which histological examination is included.

Colorectal Cancer in India: An Iceberg Analysis From North India

“…There is an overwhelming evidence in the literature for a parallelism between adenomatous polyps and colonic carcinoma. Studies done by Bat et al, Clark et al [40,41] have shown that populations that have a high incidence of polyps also have a high incidence of carcinomas and vice versa. Page 219 MIB-1 was available for only 18 cases in the study.…”

Occurrence of Colorectal Adenomas in Younger Adults: An Epidemiologic Necropsy Study

“…Although, these results are similar to ours, these investigations did not utilize epidemiologic necropsy methodology (excluding cases with premortem suspicion of colorectal neoplasia), and the data was not standardized to the general population. Additional autopsy studies exist (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) with estimates of prevalence in young adults from 3.9% to 35.7%. These investigations studied far fewer subjects, lacked exclusion criteria as mentioned above, and did not standardize the data.…”

A Descriptive Study of Colorectal Cancer in Hiwa Cancer Hospital, Sulaymaniyah, Iraq

“…A previous study demonstrated that CRC occurs in older age groups (above 70 years) (Clark et al, 1985), furthermore, however, Ono et al,(2002) have showed that the disease may occur more frequently in the middle aged group in both genders with a possible explanation that the molecular and pathophysiological changes occurring throughout the life progressively modify the molecular homeostasis of colonic epithelial cells leading to neoplasia (Ono et al, 2002). The DNA damages certainly increases in with ageing, suggesting frequent stochastic cellular insults (Taylor et al, 2003).…”