PURPOSE: The study aims to evaluate the risk of advanced histology within small colonic polyps and assess whether this risk warrants different recommendation for surveillance and treatment of such polyps. METHODS: A retrospective study of all patients undergoing their first ever colonoscopy and polypectomy in a tertiary hospital for one of three indications: screening, positive family history,and positive occult blood in stool. The histological reports of all resected polyps were retrieved and stratified according to the various polyps' sizes. Advanced neoplasia was defined as tubular adenoma ≥10 mm or any size polyp with advanced histology, i.e., villous or tubulovillous adenoma, high-grade dysplasia, intramucosal carcinoma, or invasive cancer. RESULTS: Seven hundred forty-one patients who had a total of1,192 resected polyps were included. Of polyps ≤5 mm in size, 1.6% harbored invasive cancer or high-grade dysplasia,and additional 4.1% contained villous component. The rate of advanced histology for polyps sized 6-9 mm was over 15%. The rate of advanced histology in polyps ≤5 mm was not significantly different when employing sensitivity analysis accounting for possible under or overestimation of polyp sizes by 1 and 2 mm. However, 4.6% of polyps sized 6-9 mm were found to harbor an invasive or high-grade dysplasia component when taken into account a 2-mm overestimation. CONCLUSIONS: A non-negligible fraction of small polyps harbor advanced histology. This finding suggests that expectant follow-up by non-invasive colonic imaging modalities for small polyps or not reporting them may put more than 5% of patients at risk of dysplasia progression.
PURPOSE: The study aims to evaluate the risk of advanced histology within small colonic polyps and assess whether this risk warrants different recommendation for surveillance and treatment of such polyps. METHODS: A retrospective study of all patients undergoing their first ever colonoscopy and polypectomy in a tertiary hospital for one of three indications: screening, positive family history,and positive occult blood in stool. The histological reports of all resected polyps were retrieved and stratified according to the various polyps' sizes. Advanced neoplasia was defined as tubular adenoma ≥10 mm or any size polyp with advanced histology, i.e., villous or tubulovillous adenoma, high-grade dysplasia, intramucosal carcinoma, or invasive cancer. RESULTS: Seven hundred forty-one patients who had a total of1,192 resected polyps were included. Of polyps ≤5 mm in size, 1.6% harbored invasive cancer or high-grade dysplasia,and additional 4.1% contained villous component. The rate of advanced histology for polyps sized 6-9 mm was over 15%. The rate of advanced histology in polyps ≤5 mm was not significantly different when employing sensitivity analysis accounting for possible under or overestimation of polyp sizes by 1 and 2 mm. However, 4.6% of polyps sized 6-9 mm were found to harbor an invasive or high-grade dysplasia component when taken into account a 2-mm overestimation. CONCLUSIONS: A non-negligible fraction of small polyps harbor advanced histology. This finding suggests that expectant follow-up by non-invasive colonic imaging modalities for small polyps or not reporting them may put more than 5% of patients at risk of dysplasia progression.
Authors: Michael E Zalis; Matthew A Barish; J Richard Choi; Abraham H Dachman; Helen M Fenlon; Joseph T Ferrucci; Seth N Glick; Andrea Laghi; Michael Macari; Elizabeth G McFarland; Martina M Morrin; Perry J Pickhardt; Jorge Soto; Judy Yee Journal: Radiology Date: 2005-07 Impact factor: 11.105
Authors: Hachung Yoon; Antoine Martin; Robert Benamouzig; Elisabeth Longchampt; Jacques Deyra; Stanislas Chaussade Journal: Gastroenterol Clin Biol Date: 2002-03
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Authors: N Gopalswamy; V N Shenoy; U Choudhry; R J Markert; N Peace; M S Bhutani; C J Barde Journal: Gastrointest Endosc Date: 1997-12 Impact factor: 9.427
Authors: A Graser; P Stieber; D Nagel; C Schäfer; D Horst; C R Becker; K Nikolaou; A Lottes; S Geisbüsch; H Kramer; A C Wagner; H Diepolder; J Schirra; H J Roth; D Seidel; B Göke; M F Reiser; F T Kolligs Journal: Gut Date: 2008-10-13 Impact factor: 23.059
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Authors: Silvana Marques e Silva; Viviane Fernandes Rosa; Antônio Carlos Nóbrega dos Santos; Romulo Medeiros de Almeida; Paulo Gonçalves de Oliveira; João Batista de Sousa Journal: Arq Bras Cir Dig Date: 2014 Apr-Jun