Colon adenoma features and their impact on risk of future advanced adenomas and colorectal cancer

被引：34

作者：

Calderwood, Audrey H. ^{[1
]}

Lasser, Karen E. ^{[2
]}

Roy, Hemant K. ^{[3
]}

机构：

[1] Dartmouth Hitchcock Med Ctr, Dept Med, Sect Gastroenterol, One Med Ctr Dr, Lebanon, NH 03756 USA

[2] Boston Univ, Sch Med, Dept Med, Sect Gen Internal Med, Boston, MA 02118 USA

[3] Boston Univ, Sch Med, Dept Med, Sect Gastroenterol, Boston, MA 02118 USA

来源：

WORLD JOURNAL OF GASTROINTESTINAL ONCOLOGY | 2016年 / 8卷 / 12期

基金：

美国国家卫生研究院;

关键词：

colon adenoma; colorectal cancer screening; surveillance; colonoscopy; SYNCHRONOUS ADVANCED NEOPLASIA; SERRATED POLYPS; COLONOSCOPY SURVEILLANCE; SCREENING COLONOSCOPY; BASE-LINE; INDIVIDUALS; POLYPECTOMY; GUIDELINES; SIZE; ASSOCIATION;

D O I：

10.4251/wjgo.v8.i12.826

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

AIM To review the evidence on the association between specific colon adenoma features and the risk of future colonic neoplasia [adenomas and colorectal cancer (CRC)]. METHODS We performed a literature search using the National Library of Medicine through PubMed from 1/1/2003 to 5/30/2015. Specific Medical Subject Headings terms (colon, colon polyps, adenomatous polyps, epidemiology, natural history, growth, cancer screening, colonoscopy, CRC) were used in conjunction with subject headings/key words (surveillance, adenoma surveillance, polypectomy surveillance, and serrated adenoma). We defined non-advanced adenomas as 1-2 adenomas each < 10 mm in size and advanced adenomas as any adenoma >= 10 mm size or with > 25% villous histology or high-grade dysplasia. A combined endpoint of advanced neoplasia included advanced adenomas and invasive CRC. RESULTS Our search strategy identified 592 candidate articles of which 8 met inclusion criteria and were relevant for assessment of histology (low grade vs high grade dysplasia, villous features) and adenoma size. Six of these studies met the accepted quality indicator threshold for overall adenoma detection rate > 25% among study patients. We found 254 articles of which 7 met inclusion criteria for the evaluation of multiple adenomas. Lastly, our search revealed 222 candidate articles of which 6 met inclusion criteria for evaluation of serrated polyps. Our review found that villous features, high grade dysplasia, larger adenoma size, and having >= 3 adenomas at baseline are associated with an increased risk of future colonic neoplasia in some but not all studies. Serrated polyps in the proximal colon are associated with an increased risk of future colonic neoplasia, comparable to having a baseline advanced adenoma. CONCLUSION Data on adenoma features and risk of future adenomas and CRC are compelling yet modest in absolute effect size. Future research should refine this risk stratification.

引用

页码：826 / 834

页数：9

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