Risk factors for advanced adenomas amongst small and diminutive colorectal polyps: A prospective monocenter study

Chaput, Ulriikka; Alberto, S; Terris, Benoı̂t; Beuvon, Frédéric; Audureau, Étienne; Roche, Hervé; Gaudric, M; Prat, Frédéric; Chaussade, Stanislas

doi:10.1016/j.dld.2011.02.002

Cited by 30 publications

(30 citation statements)

References 23 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: 93%

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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: 93%

See 2 more Smart Citations

Risk of cancer in small and diminutive colorectal polyps

Ponugoti

Cummings

Rex

2017

Digestive and Liver Disease

120

View full text Add to dashboard Cite

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“…A study from Taiwan revealed that 1.3% of the diminutive polyps had an advanced histology (25). Chaput et al (27) demonstrated an advanced histology in 4.7% of the diminutive, and 35.2% of the small polyps, mainly due to presence of a villous component (27). Shapiro et al (28) determined that 4.1% of the diminutive polyps contained a villous component, and the rate of advanced histology for small polyps was >15% (28).…”

Section: Patient Age ------------------------------------------------mentioning

confidence: 99%

Clinical, endoscopic and pathological characteristics of colorectal polyps in elderly patients: Single-center experience

Zhou

Zhang

Sun

et al. 2017

Molecular and Clinical Oncology

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Abstract. Increasing age is a risk factor for the development of colorectal adenomas and advanced adenomas. However, few studies have been published on the features of colorectal polyps in the elderly. The present study aimed to investigate the clinical, enteroscopic and pathological characteristics of colorectal polyps in Chinese elderly patients in a single center (The Central Hospital of Wuhan, Hubei, China). The endoscopic and pathological reports of colonoscopies performed in our center were retrospectively analyzed. A total of 7,795 consecutive patients referred for colonoscopy were evaluated between January 2013 and December 2014. Of the 297 who met the inclusion criteria, 279 polyps were observed in men and 230 in women. Of all the polyps, 263 were non-adenomatous polyps, 104 were non-advanced adenomas and 142 were advanced adenomas. 336 polyps were left-sided and 173 were right-sided. Polyps ≥10 mm were more likely to exhibit an adenomatous component and advanced features, and these findings continued to hold true when the size cut-off was set at 5 mm. The data shown in the present study have revealed that a significant number of polyps lie proximal to the splenic flexure. Thus, evaluation of the whole bowel is particularly important in elderly patients who are undergoing colonoscopy. In addition, the polyp size was associated with the presence of adenoma, and advanced component, diminutive and small polyps should not be ignored in elderly patients.

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