Abstract
Background
Patients with adenomatous polyps are at increased risk for developing colorectal cancer
based on the characteristics and number of polyps, but less is known about the individual
and combined contribution of these factors. This study aimed to better characterize
the risk of advanced adenoma and cancer in patients with positive baseline colonoscopy.
Methods
Patients who had polyps at baseline colonoscopy were included in this retrospective
cohort study (N = 1165) and were categorized into 6 groups: (1) 1–2 non-advanced adenomas (NAA’s), (2)
≥3 NAA’s, (3) advanced tubular adenoma, (4) small tubulovillous adenoma (TVA), (5)
large TVA and (6) multiple advanced adenomas (MAA’s). Findings at surveillance colonoscopy
were documented in each group.
Results
The combined incidence of advanced adenoma, ≥3 NAA’s, and colorectal cancer at surveillance
colonoscopy was significantly higher in the baseline large TVA (29.2%) than small
TVA groups (13.5%, P< 0.001), as well as in the MAA’s group (44.1%) compared with large TVA group (P = 0.02). The incidence of colorectal cancer, however, was not significantly different
between the groups.
Conclusions
The size of the polyp and the number of advanced lesions are more important than its
histology for predicting the risk of high-risk metachronous lesions at follow-up.
Keywords
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Article info
Publication history
Published online: May 16, 2017
Accepted:
May 9,
2017
Received in revised form:
May 6,
2017
Received:
September 2,
2016
Footnotes
☆Supported in part by the Josefina Maus and Gabriela Cesarman Chair for Research in Liver Diseases, the Tel Aviv University.
Identification
Copyright
© 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
