Colon polyps natural history, complications and prognosis: Difference between revisions
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|+ Risk of cancer over time<ref name="pmid29800214">{{cite journal| author=Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE| title=Association of Colonoscopy Adenoma Findings With Long-term Colorectal Cancer Incidence. | journal=JAMA | year= 2018 | volume= 319 | issue= 19 | pages= 2021-2031 | pmid=29800214 | doi=10.1001/jama.2018.5809 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29800214 }} </ref> | |+ Risk of cancer over time after initial polypectomy in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer randomized clinical trial<ref name="pmid29800214">{{cite journal| author=Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE| title=Association of Colonoscopy Adenoma Findings With Long-term Colorectal Cancer Incidence. | journal=JAMA | year= 2018 | volume= 319 | issue= 19 | pages= 2021-2031 | pmid=29800214 | doi=10.1001/jama.2018.5809 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29800214 }} </ref> | ||
! | ! | ||
! style="text-align: center;" | Cancer cases after 13 years | ! style="text-align: center;" | Cancer cases after 13 years | ||
% (n) | % (n) | ||
! style="text-align: center;" | Cancer incidence rates | ! style="text-align: center;" | Cancer incidence rates | ||
(per 10 000 person-years of observation) | (per 10 000 person-years of observation) | ||
! style="text-align: center;" | Cancer mortality compared to | |||
persons with no adenoma | |||
(relative risk) | |||
|- | |- | ||
| No adenoma | | No adenoma | ||
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| style="text-align: center;" | < 0.1% (71) | | style="text-align: center;" | < 0.1% (71) | ||
| style="text-align: center;" | 7.1 | | style="text-align: center;" | 7.1 | ||
| style="text-align: center;" | NA | |||
|- | |- | ||
| Nonadvanced adenoma | | Nonadvanced adenoma | ||
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| style="text-align: center;" | < 0.1% (55) | | style="text-align: center;" | < 0.1% (55) | ||
| style="text-align: center;" | 9.1 | | style="text-align: center;" | 9.1 | ||
| style="text-align: center;" | 1.2 | |||
(95% CI, 0.5-2.7) | |||
|- | |- | ||
| Advanced adenoma | | Advanced adenoma | ||
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(≥1 cm, high-grade dysplasia, or | (≥1 cm, high-grade dysplasia, or | ||
tubulovillous or villous histology) | tubulovillous or villous histology) | ||
| style="text-align: center;" | 0.2% | | style="text-align: center;" | 0.2% 70 | ||
| style="text-align: center;" | 20 | | style="text-align: center;" | 20 | ||
| style="text-align: center;" | 2.6 | |||
(95% CI, 1.2-5.7) | |||
|} | |} | ||
Revision as of 09:51, 15 June 2018
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Colon polyps Microchapters |
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Colon polyps natural history, complications and prognosis On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Colon polyps are very common in general population. They are usually found during screening colonoscopy. Polyps might grow gradually and cause symptoms including obstruction, bleeding, and changes in bowel habits. Some of them might progress to colorectal cancer. Therefore, it is advisable to resect all polyps that are found during colonoscopy and send the tissue biopsy for pathology. Prognosis of colon polyps is generally excellent. The presence of multiple polyps is associated with genetic disorders with a particularly poor prognosis.
Natural History, Complications, and Prognosis
Natural History
- Colon polyps are very common in general population.[1]
- They are usually found during screening colonoscopy.[2]
- Polyps might grow gradually and cause symptoms including obstruction, bleeding, and changes in bowel habits.
- Some of them might have malignant potential.
- If left untreated, it may progress to develop colorectal cancer. The progression from an adenomatous polyp to colorectal cancer may take 10-15 years.
- All polyps are recommended to be resected.
Complications
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- Gastrointestinal bleeding
- Bleeding following polypectomy
Prognosis
- Prognosis of colon polyps is generally excellent.[1]
- The presence of multiple polyps is associated with genetic disorders with a particularly poor prognosis.
- Colon polyps that are associated with BRAF and KRAS mutations have a poor prognosis.[4]
| Cancer cases after 13 years
% (n) |
Cancer incidence rates
(per 10 000 person-years of observation) |
Cancer mortality compared to
persons with no adenoma (relative risk) | |
|---|---|---|---|
| No adenoma
n = 94,248 |
< 0.1% (71) | 7.1 | NA |
| Nonadvanced adenoma
n = 65,650 |
< 0.1% (55) | 9.1 | 1.2
(95% CI, 0.5-2.7) |
| Advanced adenoma
n = 34,993 (≥1 cm, high-grade dysplasia, or tubulovillous or villous histology) |
0.2% 70 | 20 | 2.6
(95% CI, 1.2-5.7) |
References
- ↑ 1.0 1.1 Huang, Christopher S; Farraye, Francis A; Yang, Shi; O'Brien, Michael J (2010). "The Clinical Significance of Serrated Polyps". The American Journal of Gastroenterology. 106 (2): 229–240. doi:10.1038/ajg.2010.429. ISSN 0002-9270.
- ↑ 2.0 2.1 Bonnington, Stewart N (2016). "Surveillance of colonic polyps: Are we getting it right?". World Journal of Gastroenterology. 22 (6): 1925. doi:10.3748/wjg.v22.i6.1925. ISSN 1007-9327.
- ↑ Shussman, N.; Wexner, S. D. (2014). "Colorectal polyps and polyposis syndromes". Gastroenterology Report. 2 (1): 1–15. doi:10.1093/gastro/got041. ISSN 2052-0034.
- ↑ Bettington, Mark; Walker, Neal; Clouston, Andrew; Brown, Ian; Leggett, Barbara; Whitehall, Vicki (2013). "The serrated pathway to colorectal carcinoma: current concepts and challenges". Histopathology. 62 (3): 367–386. doi:10.1111/his.12055. ISSN 0309-0167.
- ↑ Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE (2018). "Association of Colonoscopy Adenoma Findings With Long-term Colorectal Cancer Incidence". JAMA. 319 (19): 2021–2031. doi:10.1001/jama.2018.5809. PMID 29800214.