Natural history of untreated colonic polyps

Stryker, Steven J.; Wolff, Bruce G.; Culp, Clyde E.; Libbe, Susan D.; Ilstrup, Duane M.; MacCarty, Robert L.

doi:10.1016/0016-5085(87)90563-4

Cited by 870 publications

(415 citation statements)

References 13 publications

Supporting

Mentioning

382

Contrasting

Unclassified

Order By: Relevance

“…Five cancers were found during the trial (CI ϭ 1.6 -11.7; 2 in arm A and 3 in arm B), while 21 were expected based on the U.S. population with the same age and sex distribution 7 and 43-48 were expected based on a comparison with 2 polyp-bearing cohorts without intervention. 8,9 All 5 cancers were asymptomatic malignant adenomas detected at surveillance colonoscopy.…”

Section: National Polyp Study Datamentioning

confidence: 99%

National Polyp Study data: Evidence for regression of adenomas

Loeve

Boer

Zauber

et al. 2004

Intl Journal of Cancer

136

View full text Add to dashboard Cite

The data of the National Polyp Study, a large longitudinal study on surveillance of adenoma patients, is used for testing assumptions on the adenoma-carcinoma sequence. The observed adenoma and colorectal cancer incidence in the National Polyp Study were compared with the simulated outcomes of the MISCAN-COLON model of epidemiology and control of colorectal cancer for the U.S. population based on expert opinion. Variants of this model were explored in order to identify assumptions on the adenoma-carcinoma sequence that are consistent with the study observations. The high observed adenoma detection rates at surveillance and low observed colorectal cancer incidence in the National Polyp Study could only be explained by assuming a high incidence rate of adenomas accompanied by regression of adenomas. The National Polyp Study data suggest that adenoma prevalence results from a dynamic process of both formation as well as regression of adenomas. This lowers the expectations for the effects of colorectal cancer screening strategies that focus on adenoma detection.

show abstract

Section: National Polyp Study Datamentioning

confidence: 99%

National Polyp Study data: Evidence for regression of adenomas

Loeve

Boer

Zauber

et al. 2004

Intl Journal of Cancer

136

View full text Add to dashboard Cite

show abstract

“…If colonoscopy is used then 1000 patients would have to be exposed to the morbidity and morality risks of colonoscopy to find 15 to 40 additional patients with proximal advanced adenomas.Only one to three additional cases of colorectal cancer per 1000 screened by FS would be expected,assuming a progression rate to cancer for advanced adenomas of 8 % by 10 years. 47 This would result in an estimated zero to two death caused by proximal colorectal cancer. If FOBT screening were to be added to FS, an additional 5 % to 10 % of advanced adenomas and cancers might be detected per year of screening.…”

Section: Efficacy Of Screening Colonoscopymentioning

confidence: 99%

Screening for gastric cancer

Hisamichi

1989

World j. surg.

134

View full text Add to dashboard Cite

Screening is a public health service wherein people of a defined population, who do not perceive that they are at risk for, or are already affected by, a disease or its complications, are asked a question or offered a test. This process identifies those who are more likely to be helped than harmed by further tests or treatment and reduces the risk of a disease or its complications.• As screening targets apparently healthy people, it has important ethical differences from clinical practice. Screening methods are not hundred percent safe and it is important that physicians and the lay public recognize this. A balance between safety and sensitivity has to be maintained. Screening has the potential to save lives or improve quality of life through early diagnosis of serious conditions, by reducing the risk of developing a condition or its complications. Screening cannot be taken as a guarantee of complete protection. In any screening program, there is an irreducible minimum of false positive results and false negative results. Screening should be considered risk reduction rather than risk elimination 1 . Following the discussion for the screening of individual cancers the statement of the National Cancer Institute (www. nci.nih.gov) is mentioned. Screening of Gastric CancerScreening of gastric cancer in asymptomatic persons may increase the chance of detecting early cancer and hence may improve the overall survival. In a study from Japan,a screening program of gastric cancer using seven -film photofluorography followed by endoscopic biopsies in suspicious cases, found that 40 % to 60 % of cancers diagnosed were early cancer, with no lymphatic metastasis. 2 This program has been attributed as one of the reasons for the decline in stomach cancer morality in Japan. However, a formal randomized study to evaluate the effectiveness of this screening strategy is lacking.As the incidence of gastric carcinoma in many developed countries is low, routine population based screening program cannot be adopted. In these countries, screening may be targeted to high -risk persons only, e.g. those with family history of gastric cancer, chronic atrophic gastritis, previous gastric surgery, or pernicious anemia.Biochemical markers to identify those at risk of developing gastric carcinoma include low serum pepsinogen I, which correlates with corpus atrophy, has been found to be significantly associated with C h a p t e r 3 7Screening for Gastrointestinal Cancers-An Overview Summary of Evidence by The National Cancer InstituteThere is insufficient evidence to establish that screening would result in a decrease in mortality from gastric cancer in the U.S. population. Endoscopy is sometimes used to screen for gastric cancer. There are serious but uncommon side effects associated with endoscopy, which may include the following: perforation, cardiopulmonary events, aspiration pneumonia, and bleeding requiring hospitalization. Screening for Esophageal CancerHigh -incidence areas, such as in northern China, may merit endoscopic screening in t...

show abstract

“…Polyp excision is important in reducing the rate of progression to carcinoma in most individuals (Muto et al, 1975;Stryker et al, 1987). Excision of polyps and early tumours is associated with a good prognosis, whereas treatment of invasive carcinomas has a less favourable outcome (Dukes, 1932).…”

mentioning

confidence: 99%

Elevated serum matrix metalloproteinase 9 (MMP-9) concentration predicts the presence of colorectal neoplasia in symptomatic patients

et al. 2007

View full text Add to dashboard Cite

Early detection of polyps or colorectal carcinoma can reduce colorectal carcinoma-associated deaths. Previous studies have demonstrated raised serum levels of matrix metalloproteinase 9 (sMMP-9) in a range of cancers. The aim of this study was to investigate the role of sMMP-9 levels in identifying colorectal neoplasia. Consenting patients donated a blood sample and were assessed by proforma-led history and physical examination. Samples were analysed for sMMP-9 concentration (enzyme-linked immuno-sorbant assay) and compared to final diagnoses. Logistic regression modelling determined independent factors associated with neoplasia. A total of 365 patients were recruited of whom 300 were analysed, including 46 normal controls. A total of 27 significant adenomas and 63 malignancies were identified. The median sMMP-9 concentration was 443ng ml À1 (IQR: 219 -782; mean: 546). Patients with neoplasia had significantly elevated sMMP-9 levels (Po0.001). Logistic regression modelling identified elevated log(sMMP-9) as the most significant predictor of neoplasia (w 2 ¼ 38.33, Po0.001). Other significant factors were age, sex, smoking history, abdominal pain and weight loss. The model accurately predicted neoplasia in 77.3% of cases. Sensitivity and specificity were 77.9 and 77.1%. sMMP-9 estimation can accurately stratify patient to low-or high-risk cohorts. Serum sampling is a potential means of avoiding unnecessary colonoscopy and reducing patient anxiety, iatrogenic morbidity and mortality, and cost.

show abstract

Natural history of untreated colonic polyps

Cited by 870 publications

References 13 publications

National Polyp Study data: Evidence for regression of adenomas

National Polyp Study data: Evidence for regression of adenomas

Screening for gastric cancer

Elevated serum matrix metalloproteinase 9 (MMP-9) concentration predicts the presence of colorectal neoplasia in symptomatic patients

Contact Info

Product

Resources

About