Endoscopic appearance of proximal colorectal neoplasms and potential implications for colonoscopy in cancer prevention

Rondagh, Eveline J.A.; Bouwens, Mariëlle; Riedl, Robert G.; Winkens, Björn; Ridder, Rogier de; Kaltenbach, Tonya; Soetikno, Roy; Masclee, Ad; Sanduleanu, Silvia

doi:10.1016/j.gie.2012.02.010

Cited by 91 publications

(72 citation statements)

References 43 publications

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“…Although estimation of the size of polyps during endoscopy could be inaccurate, many advanced adenomas in our study had a diameter of less than one centimeter and also all lesions that were located in the proximal colon had diameters less than one centimeter. Our results are comparable with other reports, and in addition emphasizes that small polyps also have the potential risk for progression towards malignancy (Strul et al, 2006;Rondagh et al, 2012).…”

Section: Discussionsupporting

confidence: 92%

Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran, Iran between 2008 and 2013

Sohrabi¹,

Zamani²,

Ajdarkosh³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Colorectal cancer (CRC) is one of the prime causes of mortality around the globe, with a significantly rising incidence in the Middle East region in recent decades. Since detection of CRC in the early stages is an important issue, and also since to date there are no comprehensive epidemiologic studies depicting the Middle East region with special attention to the average risk group, further investigation is of significant necessity in this regard. Aim: Our aim was to investigate the prevalence of preneoplastic and neoplastic lesions of the colon in an average risk population. Materials and Methods: A total of 1,208 eligible asymptomatic, average-risk adults older than 40 years of age, referred to Firuzgar Hospotal in the years 2008-2012, were enrolled. They underwent colonoscopy screening and all polypoid lesions were removed and examined by an expert gastrointestinal pathologist. The lesions were classified by size, location, numbers and pathologic findings. Size of lesions was measured objectively by endoscopists. Results: The mean age of participants was 56.5 ± 9.59 and 51.6% were male. The overall polyp detection rate was 199/1208 (16.5 %), 26 subjects having non-neoplastic polyps, including hyperplastic lesions, and 173/1208 (14.3%) having neoplastic polyps, of which 26 (2.15%) were advanced neoplasms .The prevalence of colorectal neoplasia was more common among the 50-59 age group. Advanced adenoma was more frequent among the 60-69 age group. The majority of adenomas were detected in the distal colon, but a quarter of advanced adenomas were found in the proximal colon; advance age and male gender was associated with the presence of adenoma. Conclusions: It seems that CRC screening among average-risk population might be recommended in countries such as Iran. However, sigmioidoscopy alone would miss many colorectal adenomas. Furthermore, the 50-59 age group could be considered as an appropriate target population for this purpose in Iran.

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Section: Discussionsupporting

confidence: 92%

Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran, Iran between 2008 and 2013

Sohrabi¹,

Zamani²,

Ajdarkosh³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…In an ongoing initiative, aiming to improve the quality of colonoscopic cancer prevention in South Limburg, the Netherlands, we familiarized our endoscopists on the recognition, classification, and management of nonpolypoid colorectal lesions, as described previously (24,25), with focus on quality indicators (26). Subsequently, we included all patients undergoing elective colonoscopy at our university hospital, from February 2008 to February 2010, in a cross-sectional study (i.e., derivation cohort).…”

Section: Derivation Cohort and Data Collectionmentioning

confidence: 99%

“…Colonoscopies were conducted by 8 gastroenterologists and 6 trainees, using conventional white-light colonoscopy. The endoscopists were familiarized with the detection of nonpolypoid lesions (24,25), but unaware of the main study hypothesis and clinical risk profiling associated with having serrated polyps. Complete clinical, endoscopy, and pathology data were collected and registered into a standardized database.…”

Section: Derivation Cohort and Data Collectionmentioning

confidence: 99%

“…Although the majority of SSA/Ps are featured by a large size and/or proximal location (11), recent studies suggest that a subset of SSA/Ps, in particular those harboring dysplasia, may be smaller in size and more distally located in the colon (25,30). Thus, to ensure capturing of all SSA/Ps, we specifically examined the group of LPD SPs (8-11, 25, 30-32).…”

Section: Development Of the Sp Risk Score From The Derivation Cohortmentioning

confidence: 99%

“…In an attempt to clarify the risk profile associated with having 1 LPD SP, we first trained the endoscopists in the detection of nonpolypoid colorectal lesions (24,25), with focus on quality indicators (26), and subsequently examined these risk factors in a derivation cohort. We assumed that a priori estimation of the risk for having LPD SPs may heighten the vigilance of trainees and less experienced endoscopists in detecting such lesions, thereby reducing the high variability in serrated polyp detection.…”

Section: Introductionmentioning

confidence: 99%

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Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice

Bouwens

Winkens

Rondagh

et al. 2013

Cancer Prevention Research

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Large, proximal, or dysplastic (LPD) serrated polyps (SP) need accurate endoscopic recognition and removal as these might progress to colorectal cancer. Herewith, we examined the risk factors for having 1 LPD SP. We developed and validated a simple SP risk score as a potential tool for improving their detection. We reviewed clinical, endoscopic, and histologic features of serrated polyps in a study of patients undergoing elective colonoscopy (derivation cohort). A self-administered questionnaire was obtained. We conducted logistic regression analyses to identify independent risk factors for having 1 LPD SP and incorporated significant variables into a clinical score. We subsequently tested the performance of the SP score in a validation cohort. We examined 2,244 patients in the derivation and 2,402 patients in the validation cohort; 6.3% and 8.2% had 1 LPD SP, respectively. Independent risk factors for LPD SPs were age of more than 50 years [OR 2.2; 95% confidence interval (CI), 1.3-3.8; P ¼ 0.004], personal history of serrated polyps (OR 2.6; 95% CI, 1.3-4.9; P ¼ 0.005), current smoking (OR 2.2; 95% CI, 1.4-3.6; P ¼ 0.001), and nondaily/no aspirin use (OR 1.8; 95% CI, 1.1-3.0; P ¼ 0.016). In the validation cohort, a SP score 5 points was associated with a 3.0-fold increased odds for LPD SPs, compared with patients with a score <5 points. In the present study, age of more than 50 years, a personal history of serrated polyps, current smoking, and nondaily/no aspirin use were independent risk factors for having LPD SPs. The SP score might aid the endoscopist in the detection of such lesions. Cancer Prev Res; 6(8); 855-63. Ó2013 AACR.

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Screening sigmoidoscopy and colonoscopy for reducing colorectal cancer mortality in asymptomatic persons

Phillips

Ridd

Kurien

2013

Cochrane Database of Systematic Reviews

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Endoscopic appearance of proximal colorectal neoplasms and potential implications for colonoscopy in cancer prevention

Cited by 91 publications

References 43 publications

Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran, Iran between 2008 and 2013

Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran, Iran between 2008 and 2013

Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice

Screening sigmoidoscopy and colonoscopy for reducing colorectal cancer mortality in asymptomatic persons

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