Journal ArticleDOI
Long-term risk of colorectal cancer after excision of rectosigmoid adenomas
TLDR
The long-term risk of colorectal cancer after rigid-instrument sigmoidoscopy and polypectomy in 1618 patients with rectosigmoid adenomas who did not undergo surveillance was assessed, finding that surveillance may not be of value because the risk of cancer is so low.Abstract:
Background and Methods Surveillance by repeated colonoscopy is currently recommended for patients with colorectal adenomas. We assessed the long-term risk of colorectal cancer after rigid-instrument sigmoidoscopy and polypectomy in 1618 patients with rectosigmoid adenomas (tumors of the rectum or distal sigmoid colon) who did not undergo surveillance. A total of 22,462 person-years of observation were accrued (mean, 14 years per patient). Results The incidence of subsequent rectal cancer in these patients was similar to that in the general population (standardized incidence ratio, 1.2; 95 percent confidence interval, 0.7 to 2.1). Most rectal cancers developed in patients whose adenomas had been inadequately removed; the risk was very low after complete removal. The risk of subsequent colon cancer depended on the histologic type, size, and number of adenomas in the rectosigmoid. Among 842 patients with a rectosigmoid adenoma that was tubulovillous, villous, or large (≥1 cm), colon cancer developed...read more
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Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup.
Sidney J. Winawer,A G Zauber,M N Ho,Michael J. O'Brien,Leonard S. Gottlieb,S S Sternberg,Jerome D. Waye,Melvin Schapiro,John H. Bond,Joel F. Panish +9 more
TL;DR: The results of the National Polyp Study support the view that colorectal adenomas progress to adenocarcinomas, as well as the current practice of searching for and removing adenomatous polyps to prevent coloreCTal cancer.
Journal ArticleDOI
Use of Colonoscopy to Screen Asymptomatic Adults for Colorectal Cancer
David A. Lieberman,David G. Weiss,John H. Bond,Dennis J. Ahnen,Harinder S. Garewal,Gregorio Chejfec +5 more
TL;DR: Colonoscopic screening can detect advanced colonic neoplasms in asymptomatic adults with or without distal neoplasia, and many of these neoplasm would not be detected with sigmoidoscopy.
Journal ArticleDOI
Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial
Wendy Atkin,Rob Edwards,Ines Kralj-Hans,Kate Wooldrage,Andrew Hart,J. M. A. Northover,D. Max Parkin,Jane Wardle,Stephen W. Duffy,Jack Cuzick +9 more
TL;DR: Flexible sigmoidoscopy is a safe and practical test and, when offered only once between ages 55 and 64 years, confers a substantial and longlasting benefit.
Journal ArticleDOI
American College of Gastroenterology Guidelines for Colorectal Cancer Screening 2008
Douglas K. Rex,David A. Johnson,Joe Anderson,Phillip S Schoenfeld,Carol A. Burke,John M. Inadomi +5 more
TL;DR: This document is the first update of the American College of Gastroenterology (ACG) colorectal cancer screening recommendations since 2000, and it is recognized that colonoscopy is not available in every clinical setting because of economic limitations.
Journal ArticleDOI
Systemic complications of acromegaly: epidemiology, pathogenesis, and management.
TL;DR: The most important cause of morbidity and functional disability of this disease is arthropathy, which can be reversed at an initial stage, but not if the disease is left untreated for several years.
References
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Tests for Linear Trends in Proportions and Frequencies
TL;DR: In this paper, the authors consider the fact that the carrier rate increases with the tonsil size, and it is reasonable to believe that a test specifically designed to detect a trend in the rate as the tonil size increases would show a much higher degree of significance.
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Towards safer colonoscopy: A report on the complications of 5000 diagnostic or therapeutic colonoscopies
TL;DR: Recommendations include the avoidance of oversedation, review of previous barium enema films so as to be aware of large polyps which are more likely to bleed, and the recognition of situations where perforation or septicaemia is likely to occur.
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Pathology of colorectal adenomas: a colonoscopic survey.
F Konishi,B C Morson +1 more
TL;DR: The size, histological type, and grade of dysplasia of a large series of colorectal adenomas removed by colonoscopic polypectomy were matched against other variables such as anatomical site, age, sex, and number ofAdenomas per patients to show the possible significance of severe Dysplasia as a selective marker for increased coloreCTal cancer risk.
Journal ArticleDOI
Cohort Study Analysis with a FORTRAN Computer Program
TL;DR: The program provides for movement of subjects between different 'level-of-exposure' subgroups within the cohort, and for various methods of censoring, which allows considerable flexibility in data management and is available with complete documentation and a worked example.