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Increased incidence of colorectal adenomas in follow-up evaluation of patients with newly diagnosed hyperplastic polyps.
Surg Endosc 2001; 15(7):646-8SE

Abstract

BACKGROUND

Although adenomatous polyps have been established clearly as precursor lesions for most cases of colorectal cancer, the role, if any, of hyperplastic polyps remains uncertain. The aim of the current study was to determine whether a patient with an index finding of hyperplastic polyp on colonoscopy is at increased risk for adenomatous polyps.

METHODS

We conducted a retrospective cohort study using the records of a single surgeon's colonoscopic experience over a 20-year period (June 1973 to December 1994). Patients found to have hyperplastic lesions on index colonoscopy were compared with those who had "clean" index colonoscopies. The two groups were compared for the subsequent diagnosis of adenomatous polyps on follow-up colonoscopies. Those with cancer or adenomas at index colonoscopy or in their history were excluded. We used Cox proportional hazard modeling with subsequent adenoma or cancer diagnosis at follow-up colonoscopy as the outcome, controlling for age and gender.

RESULTS

We identified 42 patients for whom hyperplastic polyps were the only colorectal neoplasms found on the index examination, in contrast to 362 control patients who had a "clean" index examination. In this cohort study, patients found to have only hyperplastic polyps on initial examination had a rate of subsequent adenoma diagnoses (42%) twice that of patients with a clean initial colonoscopy (21%). Mean follow-up time was 4.3 years. The relative rate ratio was 2.0 (95% confidence interval, 1.2-3.4).

CONCLUSIONS

This study suggests that patients found to have hyperplastic polyps on initial colonoscopic examination may have twice the risk of adenomas on follow-up colonoscopy, as compared with those who have clean initial examinations. If this finding is borne out in larger prospective studies, surveillance strategies may need to be modified accordingly.

Authors+Show Affiliations

Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. eh257@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11591960

Citation

Huang, E H., et al. "Increased Incidence of Colorectal Adenomas in Follow-up Evaluation of Patients With Newly Diagnosed Hyperplastic Polyps." Surgical Endoscopy, vol. 15, no. 7, 2001, pp. 646-8.
Huang EH, Whelan RL, Gleason NR, et al. Increased incidence of colorectal adenomas in follow-up evaluation of patients with newly diagnosed hyperplastic polyps. Surg Endosc. 2001;15(7):646-8.
Huang, E. H., Whelan, R. L., Gleason, N. R., Maeda, J. S., Terry, M. B., Lee, S. W., ... Forde, K. A. (2001). Increased incidence of colorectal adenomas in follow-up evaluation of patients with newly diagnosed hyperplastic polyps. Surgical Endoscopy, 15(7), pp. 646-8.
Huang EH, et al. Increased Incidence of Colorectal Adenomas in Follow-up Evaluation of Patients With Newly Diagnosed Hyperplastic Polyps. Surg Endosc. 2001;15(7):646-8. PubMed PMID: 11591960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased incidence of colorectal adenomas in follow-up evaluation of patients with newly diagnosed hyperplastic polyps. AU - Huang,E H, AU - Whelan,R L, AU - Gleason,N R, AU - Maeda,J S, AU - Terry,M B, AU - Lee,S W, AU - Neugut,A I, AU - Forde,K A, Y1 - 2001/05/14/ PY - 2000/03/11/received PY - 2000/11/21/accepted PY - 2001/10/10/pubmed PY - 2002/2/5/medline PY - 2001/10/10/entrez SP - 646 EP - 8 JF - Surgical endoscopy JO - Surg Endosc VL - 15 IS - 7 N2 - BACKGROUND: Although adenomatous polyps have been established clearly as precursor lesions for most cases of colorectal cancer, the role, if any, of hyperplastic polyps remains uncertain. The aim of the current study was to determine whether a patient with an index finding of hyperplastic polyp on colonoscopy is at increased risk for adenomatous polyps. METHODS: We conducted a retrospective cohort study using the records of a single surgeon's colonoscopic experience over a 20-year period (June 1973 to December 1994). Patients found to have hyperplastic lesions on index colonoscopy were compared with those who had "clean" index colonoscopies. The two groups were compared for the subsequent diagnosis of adenomatous polyps on follow-up colonoscopies. Those with cancer or adenomas at index colonoscopy or in their history were excluded. We used Cox proportional hazard modeling with subsequent adenoma or cancer diagnosis at follow-up colonoscopy as the outcome, controlling for age and gender. RESULTS: We identified 42 patients for whom hyperplastic polyps were the only colorectal neoplasms found on the index examination, in contrast to 362 control patients who had a "clean" index examination. In this cohort study, patients found to have only hyperplastic polyps on initial examination had a rate of subsequent adenoma diagnoses (42%) twice that of patients with a clean initial colonoscopy (21%). Mean follow-up time was 4.3 years. The relative rate ratio was 2.0 (95% confidence interval, 1.2-3.4). CONCLUSIONS: This study suggests that patients found to have hyperplastic polyps on initial colonoscopic examination may have twice the risk of adenomas on follow-up colonoscopy, as compared with those who have clean initial examinations. If this finding is borne out in larger prospective studies, surveillance strategies may need to be modified accordingly. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/11591960/Increased_incidence_of_colorectal_adenomas_in_follow_up_evaluation_of_patients_with_newly_diagnosed_hyperplastic_polyps_ L2 - https://dx.doi.org/10.1007/s004640000389 DB - PRIME DP - Unbound Medicine ER -