Prevalence of advanced histological features in diminutive and small colon polyps

Gupta, Neil; Bansal, Ajay; Rao, Deepthi; Early, Dayna S.; Jonnalagadda, Sreenivasa S.; Wani, Sachin; Edmundowicz, Steven A.; Sharma, Prateek; Rastogi, Amit

doi:10.1016/j.gie.2012.01.020

Cited by 169 publications

(145 citation statements)

References 28 publications

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“…Our results are consistent with much of the previously published literature [3][4][5][6][7][8][9][10][11][12][13][14][15][20][21][22][23][24][25][26][27] , particularly reports from the last 10 years ( Table 2). As noted earlier, the trends toward decreasing prevalence rates of cancer in small and diminutive polyps may reflect the improved imaging capabilities of colonoscopes, and increasing emphasis on identification of flat lesions which do not increase the risk of cancer compared to polypoid lesions [16][17][18] .…”

supporting

confidence: 92%

“…The overall distribution of polyp sizes in this study suggests that the tendency of endoscopists in our unit is to underestimate polyp size, particularly since the percentage of all polyps < 1 cm in size was comparable to other studies [3][4][5][6][7][8][9][10][11][12][13][14][15][21][22][23][24][25][26][27] , despite our center receiving many referrals for large and complex polypectomies 28 . Further the fraction of polyps ≤ 5 mm and 6-9 mm in size was comparable to or higher than prior studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][22][23][24][25][26][27][28][29] .…”

supporting

confidence: 79%

“…Further the fraction of polyps ≤ 5 mm and 6-9 mm in size was comparable to or higher than prior studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][22][23][24][25][26][27][28][29] . Any underestimation of polyp size would tend to cause the apparent prevalence of cancer in polyps of different size ranges to increase.…”

supporting

confidence: 78%

“…However, more recent colonoscopic studies found a much lower prevalence [8][9][10][11][12][13][14][15] . These differences may reflect in part the improved potential for polyp identification resulting from progressive improvements in colonoscope imaging.…”

Section: Introductionmentioning

confidence: 92%

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Risk of cancer in small and diminutive colorectal polyps

Ponugoti

Cummings

Rex

2017

Digestive and Liver Disease

120

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The prevalence of cancer in small and diminutive polyps is relevant to "resect and discard" and CT colonography reporting recommendations.We evaluated a prospectively collected colonoscopy polyp database to identify polyps < 10 mm and those with cancer or advanced histology (high-grade dysplasia or villous elements)Of 32,790 colonoscopies, 15,558 colonoscopies detected 42,630 polyps < 10 mm in size. A total of 4,790 lesions were excluded as they were not conventional adenomas or serrated class lesions.There were 23,524 conventional adenomas < 10 mm of which 22,952 were tubular adenomas.There were 14,316 serrated class lesions of which 13,589 were hyperplastic polyps and the remainder were sessile serrated polyps. Of all conventional adenomas, 96 had high-grade dysplasia including 0.3% of adenomas ≤ 5 mm in size and 0.8% of adenomas 6-9 mm in size. Of all conventional adenomas, 2.1% of those ≤ 5 mm in size and 5.6% of those 6-9 mm in size were advanced. Among 36,107 polyps ≤ 5 mm in size and 6,523 polyps 6-9 mm in size, there were no cancers.These results support the safety of resect and discard as well as current CT colonography reporting recommendations for small and diminutive polyps.

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supporting

confidence: 92%

supporting

confidence: 79%

supporting

confidence: 78%

Section: Introductionmentioning

confidence: 92%

See 2 more Smart Citations

Risk of cancer in small and diminutive colorectal polyps

Ponugoti

Cummings

Rex

2017

Digestive and Liver Disease

120

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“…This is also the situation in screening colonoscopy, with reported proportions of adenomas < 5 mm of around 80% [20]. A significant proportion of diminutive polyps, between 23% and 40%, are not even adenomas [21][22][23][24]. Overall, the prevalence of advanced histology in diminutive polyps seems low, although there is some heterogeneity in the literature due to different inclusion criteria (screening versus symptomatic patients; patients only with polyps less than a specific size, etc.…”

Section: Introductionmentioning

confidence: 98%