Colonic Polyps Are Different in the UK Bowel Cancer Screening Programme Population Compared to the Symptomatic Population

Pathology of polyps detected in the bowel cancer screening programme

“…25,26 There is a higher overall prevalence of polyps in screening populations and screen-detected lesions appear more likely to be adenomatous compared with symptomatic series (72e79%, versus 47e62%, respectively). 17,27 Lower proportions of purely villous and high grade lesions have been identified among symptomatic cases 28,29 while screendetected series show higher rates of large (>10 mm) or multiple polyps and adenocarcinoma.…”

A prospective case controlled study of the short‐term outcome following hemicolectomy for benign compared with malignant colonic polyps

“…Hemicolectomy with en bloc mesenteric resection is the established treatment for colonic polyps unsuitable for endoscopic removal. Before the bowel cancer screening programme, about 1000 patients underwent colectomy for benign colonic neoplasia in England each year and recent publications have suggested that this number has since increased . To our knowledge this is the first study designed specifically to compare the outcome after segmental colectomy for benign and malignant neoplasms and shows that the complications are similar other than a slight increase in hospital stay in the benign group.…”

“…The National Bowel Cancer Screening Programme in England has resulted in a significant shift in diagnosis of large bowel tumours towards early stage disease with approximately 40% of patients being diagnosed with Stage I colorectal cancer . The screened population also tends to have more benign polyps larger than those found in symptomatic patients .…”

Full-thickness laparoendoscopic colonic excision in an experimental model

“…Colorectal cancer screening has resulted in more patients requiring surgery for stage I cancer and complex polyps. Patients may not benefit from the current standard treatment, in which the mesenteric lymph nodes are removed at colectomy.…”