| Theme | Can we change to treat for diminutive colorectal polyp ? | |
|---|---|---|
| Title | Clinical strategy for colorectal diminutive adenomatous polyps. Remove or observe ? | |
| Publish Date | 2014/05 | |
| Author | Yosuke Otake | Endoscopy Division, National Cancer Center Hospital |
| Author | Minori Matsumoto | Endoscopy Division, National Cancer Center Hospital |
| Author | Yasuo Kakugawa | Endoscopy Division, National Cancer Center Hospital |
| Author | Taku Sakamoto | Endoscopy Division, National Cancer Center Hospital |
| Author | Takeshi Nakajima | Endoscopy Division, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Endoscopy Division, National Cancer Center Hospital |
| Author | Yutaka Saito | Endoscopy Division, National Cancer Center Hospital |
| Author | Yukio Muramatsu | Screening Technology and Development Division, Reserch Center for Cancer Prevention and Screening, National Cancer Center |
| [ Summary ] | Diminutive adenomatous polyps rarely possess a histologically carcinomatous component and present a high risk of growing in size. In this longitudinal study, we assess the incidence of advanced neoplasia detected during follow-up colonoscopies for patients who were found to have diminutive (<5 mm) adenomatous polyps during initial screening colonoscopies but were not referred for removal. Advanced neoplasia was defined as low-grade dysplasia ≥10 mm, adenomas with a high-grade dysplasia components, or carcinoma. Advanced neoplasia was detected in 12 (2.1 % ; 95 % CI 1.14 % to 3.56 %) of 573 patients during follow-up colonoscopies over a median interval of five years. All advanced neoplasias detected were curatively treated with endoscopic resection. Risk of advanced neoplasia did not increase even when diminutive adenomatous polyps were untreated at screening. Our non-referral strategy was considered to be acceptable, provided such patients undergo recommended follow-up colonoscopies. This approach can be applied to colorectal cancer screening using CT colonography and colon capsule endoscopy. | |