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PubMed1986

The incidence and prevalence of familial polyposis coli in Denmark.

Based on the Danish Polyposis Register, the frequency of familial polyposis coli was estimated at the end of 1982. The mean annual incidence rate of polyposis coli has remained rather constant at approximately 1 X 10(-6) X yr-1 since the forties. The life-time risk of developing polyposis coli is about 1 X 10(-4). The point prevalence rate was 26 X 10(-6) at the end of 1982. The number of cases found in sibs and children of probands made it probable that a nation-wide prophylactic examination of first degree relatives resulted in a complete identification of affected family members. The completeness of the Danish Polyposis Register in the period 1976-82 was estimated to be 90% and the validity of the diagnosis is considered to be 100%.

Adolescent↗
PubMed2006

Conventional colonoscopy and magnified chromoendoscopy for the endoscopic histological prediction of diminutive colorectal polyps: a single operator study.

AIM: To accurately differentiate the adenomatous from the non-adenomatous polyps by colonoscopy. METHODS: All lesions detected by colonoscopy were first diagnosed using the conventional view followed by chromoendoscopy with magnification. The diagnosis at each step was recorded consecutively. All polyps were completely removed endoscopically for histological evaluation. The accuracy rate of each type of endoscopic diagnosis was evaluated, using histological findings as gold standard. RESULTS: A total of 240 lesions were identified, of which 158 (65.8%) were non-neoplastic and 82 (34.2%) were adenomatous. The overall diagnostic accuracy of conventional view, and chromoendoscopy with magnification was 76.3% (183/240) and 95.4% (229/240), respectively (P<0.001). CONCLUSION: The combination of colonoscopy and magnified chromoendoscopy is the most reliable non-biopsy method for distinguishing the non-neoplastic from the neoplastic lesions.

Adenomatous Polyps↗
PubMedDate not supplied

Rate of progression to advanced stage in depressed-type colorectal adenoma.

To better estimate the likelihood of depressed-type adenoma developing into more advanced colorectal cancer, we assumed that a given colorectal cancer had a depressed type origin when depressed non-polypoid-type cancerous glands remained microscopically identifiable. Among 100 adenomas, depressed non-polypoid-type glands were found in 15, and lesion size in tumor with depressed non-polypoid type did not differ from that in others. Among 100 submucosally invasive cancers, depressed non-polypoid-type glands were found in 14, and lesion size in tumor with depressed non-polypoid-type did not differ from that in others. Among 100 cancers invading the muscularis propria, depressed non-polypoid-type glands were found in 15; these were significantly smaller lesions than those without depressed non-polypoid-type cancers (p<0.05). Among 100 more deeply invasive cancers, depressed non-polypoid-type grands were found in 16, with no difference in size from other similarly invasive lesions. We concluded that the rate of depressed-type adenoma progression to invasive cancer was about 15% and that depressed non-polypoid-type cancers are likely to invade the muscularis propria even when smaller than cancers of other types.

Adenoma↗
PubMedDate not supplied

[Endoscopic treatment of colorectal polyps in a digestive endoscopy outpatient department].

The aim of this report was to evaluate the effectiveness of the endoscopic treatment of colonic polyps to allow secondary prophylaxis in order to prevent the onset of cancer arising from adenomas. From October 2002 to January 2004 we performed 487 colonoscopies on a patient group with the following indications: screening prior to kidney transplant; screening for colorectal cancer (patients positive at faecal occult blood testing); follow-up of patients who had undergone colonic resections for colorectal cancer; patients with other diseases. Colorectal polyps were diagnosed in 15 males and 15 females, with a mean age of 63 years. All the neoplasms were resected during colonoscopy and specimens sent for histological study. The histological examinations yielded the following results: 4 hyperplastic polyps; 9 tubular adenomas (6 with mild, 2 with mild-to-moderate, and 1 with severe dysplasia); 8 tubulo-villous adenomas (3 with mild, 1 with mild-to-moderate, and 4 with moderate dysplasia); 4 villous adenomas (3 with mild and 1 with severe dysplasia); 1 adenocarcinoma; 1 inflammatory polyp; in 3 cases we were unable to retrieve the polyps after polypectomy. Colonoscopic detection of a neoplasm allows us to remove it and send to the pathology laboratory for definitive histological diagnosis. Moreover, snare polypectomy can be a radical treatment for dysplastic polyps without stromal axis and basal membrane infiltration. We therefore conclude that colonoscopy allows not only early diagnosis of colonic neoplasms, but also radical curative treatment in the early stages.

Ambulatory Surgical Procedures↗
PubMed2005

[Clinical, enteroscopic, and pathological characteristics of 796 cases of colorectal polyps].

OBJECTIVE: To study the age, clinical, enteroscopic and pathological characteristics of colorectal polyps and factors affected polyp-carcinoma. METHODS: We analyzed the clinical, enteroscopic and pathological characteristics of 7276 cases of colorectal polyps. RESULTS: The incidence of colorectal polyps was 10.94%, including 521 men and 275 women. The rate of colorectal polyp was 82.29% in 30-69 year olds. The adenomatous, inflammatory, hyperplastic and juvenile polyps were 43.84%, 42.09%, 11.06% and 1.51%, respectively. Polypoid lesions were located at cecum 3.29%, ascending 11.88%, transverse 4.89%, descending 11.58%, sigmoid 26.05%, and rectum 42.32%. Thirty-five cases (4.4%) were found to have polpous canceration. The canceration rates in villous, mixed and tubular adenomas were 29.73%, 11.11%, and 4.86%. The rate of canceration seemed to depend on its dimensions, being 1.3%, 7.4%, and 25.6% for the 0.6 - 1.0 cm, 1.1 - 1.9 cm, and > or = 2.0 cm in size, respectively. Conclusion The ages between 30-69 tend to suffer from colorectal polyps. The incidence in the male is higher than that in the female. Colorectal polyps are more likely to locate in left colon. The common pathological types were adenomatous and inflammatory polyps. There is a high canceration of polyps in the left colon, villous adenomas and > or = 2.0 cm polyps. The broader the pedicles and the larger the diameters of polyps are, the higher the canceration rate. All of the colon polyps should be excised and undergo the pathological examination. Enteroscopic polypectomy helps prevent colorectal polpous canceration.

Adenoma↗
PubMed1991

Prevalence and malignant potential of colorectal polyps in asymptomatic, average-risk men.

Screening colonoscopy was performed on 119 asymptomatic elderly men with no other risk factors for colonic neoplasms. Ninety adenomas were detected in 49 (41%) subjects. Mean adenoma size was 6.5 mm, with 83 (92%) less than or equal to 10 mm. Forty-nine (54%) adenomas were located proximal to the splenic flexure, and 17 (19%) were classified as tubulovillous or villous. Moderate- to high-grade dysplasia was found in 29 (32%) adenomas and was associated with larger size (p less than 0.0001) and villous architecture (p = 0.0038). Two subjects harbored adenomas with invasive cancer. Seventy-one hyperplastic polyps were found in 40 (34%) subjects. The mean size of hyperplastic polyps was 3.4 mm, and 64 (90%) were located in the left colon. We conclude that, in this population, adenomas are common lesions that are frequently small. However, substantial proportions of these adenomas may be at risk for malignant degeneration due to the presence of villous architecture and higher grades of dysplasia. Because adenomas and hyperplastic polyps are endoscopically indistinguishable, all polyps found at endoscopy should be removed or ablated.

Aged↗
PubMed1991

[Colorectal hyperplasic polyps in the population of Côte-d'Or, between 1976 and 1985].

The data of the polyp registry of the Côte d'Or was used to study the characteristics of hyperplasic polyps detected in a well defined-population. In the 1976-1985 10-yr period, 1,222 hyperplasic polyps were resected in 874 Côte d'Or residents. They represented 17% of all polyps. The incidence rate standardized according to the world reference population was 21.9/100,000 in males and 8.1/100,000 in female. The male predominance was observed in all age groups. The incidence of hyperplasic polyps increased by a mean of 19.8% per year in males and 26.6% in females (P less than 0.001). Hyperplasic polyps were discovered twice as often in patients living in an urban area than in patients living in a rural area (P less than 0.001). Hyperplasic polyps were smaller than 5 mm in 91.4% of cases and were located in the rectum in 59.4% of the cases. They were associated with an adenoma in 21.0% of the cases. In the case of a rectal hyperplasic polyp, 10.5% of the patients had an adenoma in the left colon and 2.8% in the right colon. A rectal hyperplasic polyp cannot be considered as a marker of the presence of a large bowel adenoma. The relationship between hyperplasic polyp and colorectal cancer needs to be established.

Adenoma↗
PubMed1989

[The role of epidemiologic research of the natural history of cancer for evaluating cancer screening programs--a prospective study of colorectal polyps on the occurrence of colorectal cancer].

In order to elucidate the natural history of colorectal polyps and to examine the effectiveness of endoscopic polypectomy in reducing the incidence of colorectal cancer, we conducted a retrospective cohort study of all patients who had undergone endoscopic examination at the Center for Adult Diseases, Osaka in 1970-82. The study subjects consist of 653 non-polyp cases and 431 colorectal polyp cases including 222 cases treated by endoscopic polypectomy. These were followed up until the end of 1985 by the method of a record linkage with the Osaka Cancer Registry's file. The colorectal polyp group and the endoscopic polypectomy group experienced 4.4 and 2.9 times, respectively, as much incidence of colorectal cancer as the non-polyp group. The magnitude of the prevented fraction by the use of endoscopic polypectomy was estimated at 31.3%. A large-scale and long-term study is necessary to elucidate the original study purpose.

Adult↗