Growth of colorectal polyps: redetection and evaluation of unresected polyps for a period of three years.
B. Hofstad,Morten H. Vatn,Solveig Norheim Andersen,H. S. Huitfeldt,Torleiv O. Rognum,S Larsen,M. Osnes +6 more
TLDR
The results show that follow up of unresected colorectal polyps up to 9 mm is safe, and the consistency of growth retardation of medium sized polyps suggests extended intervals between the endoscopic follow up examinations, but the increased number of new polyps in the proximal colon indicates total colonoscopy as the examination of choice.Abstract:
BACKGROUND, AIMS, AND PATIENTS: In a prospective follow up and intervention study of colorectal polyps, leaving all polyps less than 10 mm in situ for three years, analysis of redetection rate, growth, and new polyp formation was carried out in 116 patients undergoing annual colonoscopy. The findings in relation to growth and new polyp formation were applied to 58 subjects who received placebo. RESULTS: Redetection rate varied from 75-90% for each year, and was highest in the rectum and sigmoid colon. There was no net change in size of all polyps in the placebo group, however, polyps less than 5 mm showed a tendency to net growth, and polyps 5-9 mm a tendency to net regression in size, both for adenomas and hyperplastic polyps. This pattern was verified by computerised image analysis. Patients between 50 and 60 years showed evidence of adenoma size increase compared with the older patients, and the same was true for those with multiple adenomas (four to five) compared with those with a single adenoma. The new adenomas were significantly smaller and 71% were located in the right side of the colon. Patients with multiple adenomas had more new polyps at all the follow up examinations than patients with a single adenoma. One patient developed an invasive colorectal carcinoma, which may be evolved from a previously overlooked polyp. Two polyps, showing intramucosal carcinoma after follow up for three years, were completely removed, as judged by endoscopy and histological examination. CONCLUSIONS: The results show that follow up of unresected colorectal polyps up to 9 mm is safe. The consistency of growth retardation of medium sized polyps suggests extended intervals between the endoscopic follow up examinations, but the increased number of new polyps in the proximal colon indicates total colonoscopy as the examination of choice. The growth retardation of the medium sized polyps may partly explain the discrepancy between the prevalence of polyps and the incidence of colorectal cancer.read more
Citations
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Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases
TL;DR: In this paper, the authors provide the best available information on the effect of anti-oxidants on mortality in patients with various diseases, including cancer, heart disease, and stroke.
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CT colonography versus colonoscopy for the detection of advanced neoplasia.
David H. Kim,Perry J. Pickhardt,Andrew J. Taylor,Winifred K. Leung,Thomas C. Winter,J. Louis Hinshaw,Deepak V. Gopal,Mark Reichelderfer,Richard H. Hsu,Patrick R. Pfau +9 more
TL;DR: Primary CTC and OC screening strategies resulted in similar detection rates for advanced neoplasia, although the numbers of polypectomies and complications were considerably smaller in the CTC group, which supports the use of CTC as a primary screening test before therapeutic OC.
Journal ArticleDOI
CT colonography reporting and data system: a consensus proposal.
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 A. Soto,Judy Yee +13 more
TL;DR: A practical guide to the interpretation of CT colonography results: the CT Colonography Reporting and Data System, or “C-RADS,” is presented, which is coupled to recommendations for follow-up.
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Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology
TL;DR: Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology.
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Population-based surveillance by colonoscopy: effect on the incidence of colorectal cancer. Telemark Polyp Study I.
TL;DR: Endoscopic screening examination with polypectomy and follow-up was shown to reduce the incidence of CRC in a Norwegian normal population and the possible effect of screening on overall mortality should be addressed in larger studies.
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Practical statistics for medical research
TL;DR: Practical Statistics for Medical Research is a problem-based text for medical researchers, medical students, and others in the medical arena who need to use statistics but have no specialized mathematics background.
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Genetic alterations during colorectal-tumor development.
Bert Vogelstein,Eric R. Fearon,Stanley R. Hamilton,Scott E. Kern,Ann C. Preisinger,Mark Leppert,A M Smits,Johannes L. Bos +7 more
TL;DR: It is found that ras-gene mutations occurred in 58 percent of adenomas larger than 1 cm and in 47 percent of carcinomas, which are consistent with a model of colorectal tumorigenesis in which the steps required for the development of cancer often involve the mutational activation of an oncogene coupled with the loss of several genes that normally suppress tumors.
Journal ArticleDOI
Randomized Comparison of Surveillance Intervals after Colonoscopic Removal of Newly Diagnosed Adenomatous Polyps
Sidney J. Winawer,A G Zauber,Michael J. O'Brien,M N Ho,Lawrence J. Gottlieb,S S Sternberg,Jerome D. Waye,John H. Bond,Melvin Schapiro,Stewart Et +9 more
TL;DR: Colonoscopy performed three years after colonoscopic removal of adenomatous polyps detects important colonic lesions as effectively as follow-up colonoscopy after both one and three years.
Journal ArticleDOI
A Clinical Trial of Antioxidant Vitamins to Prevent Colorectal Adenoma
E. Robert Greenberg,John A. Baron,Tor D. Tosteson,Daniel H. Freeman,Gerald J. Beck,John H. Bond,Thomas A. Colacchio,John A. Coller,Harold D. Frankl,Robert W. Haile,Jack S. Mandel,David W. Nierenberg,Richard I. Rothstein,Dale C. Snover,Marguerite Stevens,Robert W. Summers,Rosalind U. van Stolk +16 more
TL;DR: The lack of efficacy of these vitamins argues against the use of supplemental beta carotene and vitamins C and E to prevent colorectal cancer.