OBJECTIVE: Colonoscopy may fail to prevent colorectal cancer, especially in the proximal colon and in women. Nonpolypoid colorectal neoplasms may potentially explain some of these post-colonoscopy cancers. In the present study, we aimed to examine the prevalence and malignant potential of nonpolypoid colorectal neoplasms in a large population, with special attention to gender and location. METHODS: We performed a cross-sectional study of all consecutive patients undergoing elective colonoscopy at a single academic medical center. The endoscopists were familiarized on the detection and treatment of nonpolypoid lesions. Advanced histology was defined by the presence of high-grade dysplasia or early cancer. RESULTS: We included 2310 patients (53.9% women, mean age 58.4 years) with 2143 colorectal polyps. Prevalences of colorectal neoplasms and nonpolypoid colorectal neoplasms were lower in women than in men (20.9% vs. 33.7%, p < 0.001 and 3.0% vs. 5.5%, p = 0.002). In women, nonpolypoid colorectal neoplasms were significantly more likely to contain advanced histology than polypoid ones (OR 2.89, 95% CI 1.24-6.74, p = 0.01), while this was not the case in men (OR 0.91, 95% CI 0.40-2.06, p = 0.83). Proximal neoplasms with advanced histology were more likely to be nonpolypoid than distal ones (OR 4.68, 95% CI 1.54-14.2, p = 0.006). CONCLUSION: Nonpolypoid mechanisms may play an important role in colorectal carcinogenesis, in both women and men. Although women have fewer colorectal neoplasms than men, they have nonpolypoid colorectal neoplasms, which frequently contain advanced histology.
OBJECTIVE: Colonoscopy may fail to prevent colorectal cancer, especially in the proximal colon and in women. Nonpolypoid colorectal neoplasms may potentially explain some of these post-colonoscopy cancers. In the present study, we aimed to examine the prevalence and malignant potential of nonpolypoid colorectal neoplasms in a large population, with special attention to gender and location. METHODS: We performed a cross-sectional study of all consecutive patients undergoing elective colonoscopy at a single academic medical center. The endoscopists were familiarized on the detection and treatment of nonpolypoid lesions. Advanced histology was defined by the presence of high-grade dysplasia or early cancer. RESULTS: We included 2310 patients (53.9% women, mean age 58.4 years) with 2143 colorectal polyps. Prevalences of colorectal neoplasms and nonpolypoid colorectal neoplasms were lower in women than in men (20.9% vs. 33.7%, p < 0.001 and 3.0% vs. 5.5%, p = 0.002). In women, nonpolypoid colorectal neoplasms were significantly more likely to contain advanced histology than polypoid ones (OR 2.89, 95% CI 1.24-6.74, p = 0.01), while this was not the case in men (OR 0.91, 95% CI 0.40-2.06, p = 0.83). Proximal neoplasms with advanced histology were more likely to be nonpolypoid than distal ones (OR 4.68, 95% CI 1.54-14.2, p = 0.006). CONCLUSION: Nonpolypoid mechanisms may play an important role in colorectal carcinogenesis, in both women and men. Although women have fewer colorectal neoplasms than men, they have nonpolypoid colorectal neoplasms, which frequently contain advanced histology.
Authors: Mariëlle W E Bouwens; Rogier de Ridder; Ad A M Masclee; Ann Driessen; Robert G Riedl; Bjorn Winkens; Silvia Sanduleanu Journal: World J Gastroenterol Date: 2013-07-21 Impact factor: 5.742
Authors: Quirinus J M Voorham; Jerry Janssen; Marianne Tijssen; Suzanne Snellenberg; Sandra Mongera; Nicole C T van Grieken; Heike Grabsch; Martin Kliment; Bjorn J Rembacken; Chris J J Mulder; Manon van Engeland; Gerrit A Meijer; Renske D M Steenbergen; Beatriz Carvalho Journal: BMC Cancer Date: 2013-12-19 Impact factor: 4.430
Authors: Lik Hang Lee; Marietta Iacucci; Miriam Fort Gasia; Subrata Ghosh; Remo Panaccione; Stefan Urbanski Journal: Can J Gastroenterol Hepatol Date: 2017-01-15
Authors: Roel M M Bogie; Bjorn Winkens; Sean J J Retra; Chantal M C le Clercq; Mariëlle W Bouwens; Eveline J A Rondagh; Li-Chun Chang; Rogier de Ridder; Chantal Hoge; Jan-Willem Straathof; Danny Goudkade; Silvia Sanduleanu-Dascalescu; Ad A M Masclee Journal: United European Gastroenterol J Date: 2021-02-18 Impact factor: 4.623