Prevalence of nonpolypoid colorectal neoplasia: An Italian multicenter observational study

Bianco, Maria Antonia; Cipolletta, Livio; Rotondano, G.; Buffoli, Federico; Gizzi, G.; Tessari, F.

doi:10.1055/s-0029-1244020

Cited by 66 publications

(37 citation statements)

References 17 publications

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“…Thus, increasing emphasis on maximizing adenoma detection could result in a broader range of lesions removed, including many with a more subtle and flat morphology than was detectable in early studies. Contrary to some suggestions, flat morphology without depression is not associated with an increased risk of advanced pathology and may be associated with a lower risk of advanced pathology [16][17][18] .…”

Section: Introductioncontrasting

confidence: 81%

“…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%

“…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] .…”

mentioning

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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Section: Introductioncontrasting

confidence: 81%

supporting

confidence: 78%

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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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“…Because of nonspecific characterization and the flat pattern, it would easily be missed if not carefully looked for (8). For a long time, Western researchers think that such cancer is uncommon in Western populations, whereas with the progress of technology, a high number of NP-CRNs are discovered in Western countries (9)(10)(11).…”

Section: Wang Et Al a Contrastive Study Of Two Countries' Colonoscopmentioning

confidence: 99%

A comparative analysis of colonoscopy findings in a Chinese and American tertiary hospital

Wang

Cai²,

Zhu³

et al. 2015

Turk J Gastroenterol

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Background/Aims: To compare the colonoscopy findings of a tertiary Chinese hospital with those of an American tertiary hospital. Materials and Methods: Hundred consecutive colonoscopies performed in August 2008 at the First Affiliated Hospital of Nanchang University in China and at the Emory University Hospital, United States of America, were investigated. The endoscopic findings and the histopathology results were statistically compared. Results: The average age of Chinese patients who underwent colonoscopy in this study was 45.23±15.38 years, whereas that of American patients was 55.38±12.11 years; no difference in sex ratio was observed (p=0.202) between the two populations. Screening colonoscopy accounted for 38% of patients in the American group and zero patients in the Chinese group. Polyps and diverticula were the most common findings in both groups. Abnormal findings in the American patients were three times higher than those in the Chinese patients. Proximal colon polyps were more common in the American group. Conversely, proximal colon diverticula were more common in the Chinese group. The prevalence of non-neoplasm lesions was not different between the two groups (p=0.232); the prevalence of adenomas significantly increased in patients who were more than 50 years old in both groups and was higher in the American group (p=0.038). Conclusion:The prevalence of bowel diseases in American patients was higher than that in Chinese patients. Polyps and diverticula were the main bowel abnormalities in both groups. Chinese patients lacked awareness of colonoscopy screening and should be enhanced aged 50 years old or older, because the prevalence of advanced neoplasia was increased in this age group in both groups.

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“…However, in the past 2 decades it has become clear that the molecular basis of colorectal cancer is complex, and that the precursor lesions of cancer vary by histology and morphology in the right versus left colon. For example, for Paris classification type II lesions (flat and depressed lesions), the distribution of these lesions is shifted toward the right colon 10 . In addition, a hypermethylation or serrated pathway occurs primarily in the right colon 11 , and the precursor lesion (the sessile serrated polyp or sessile serrated adenoma) is universally flat or sessile, consistently similar in color to the surrounding normal mucosa 12,13 , and more subject to failed detection and incomplete resection compared to conventional adenomas 14,15 .…”

Section: Introduction and Historical Perspective On Screening Colonosmentioning

confidence: 99%

Colonoscopy: The Current King of the Hill in the USA

Rex

2014

Dig Dis Sci

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Colonoscopy is the dominant colorectal cancer screening strategy in the United States.There are no randomized controlled trials completed of screening colonoscopy, but multiple lines of evidence establish that colonoscopy reduces colorectal cancer incidence in both the proximal and distal colon. Colonoscopy is highly operator dependent, but systematic efforts to measure and improve quality are impacting performance.Colonoscopy holds a substantial advantage over other strategies for detection of serrated lesions, and a recent case-control study suggests that once-only colonoscopy or colonoscopy at 20 year intervals, by a high level detector, could ensure lifetime protection from colorectal cancer for many patients. 3Introduction and historical perspective on screening colonoscopy

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Prevalence of nonpolypoid colorectal neoplasia: An Italian multicenter observational study

Abstract: NPLs are relatively common in the Italian population, with a prevalence similar to that in other Western series. NPLs are not more aggressive than polypoid lesions, except for those with depressed morphology.

Cited by 66 publications

References 17 publications

Risk of cancer in small and diminutive colorectal polyps

Risk of cancer in small and diminutive colorectal polyps

A comparative analysis of colonoscopy findings in a Chinese and American tertiary hospital

Colonoscopy: The Current King of the Hill in the USA

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