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Objective: Although serrated polyps may be precursors of colorectal cancer (CRC), prospective data on the long-term CRC risk in individuals with serrated polyps are lacking.
Design: In a population-based randomised trial, 12,955 individuals aged 50-64 years were screened with flexible sigmoidoscopy, while 78 220 individuals comprised the control arm. We used Cox models to estimate HRs with 95% CIs for CRC among individuals with ≥1 large serrated polyp (≥10 mm in diameter), compared with individuals with adenomas at screening, and to population controls, and multivariate logistic regression to assess polyp risk factors for CRC.
Results: A total of 103 individuals had large serrated polyps, of which 81 were included in the analyses. Non-advanced adenomas were found in 1488 individuals, advanced adenomas in 701. Median follow-up was 10.9 years. Compared with the control arm, the HR for CRC was 2.5 (95% CI 0.8 to 7.8) in individuals with large serrated polyps, 2.0 (95% CI 1.3 to 2.9) in individuals with advanced adenomas and 0.6 (95% CI 0.4 to 1.1) in individuals with non-advanced adenomas. A large serrated polyp was an independent risk factor for CRC, adjusted for histology, size and multiplicity of concomitant adenomas (OR 3.3; 95% CI 1.3 to 8.6). Twenty-three large serrated polyps found at screening were left in situ for a median of 11.0 years. None developed into a malignant tumour.
Conclusions: Individuals with large serrated polyps have an increased risk of CRC, comparable with individuals with advanced adenomas. However, this risk may not be related to malignant growth of the serrated polyp.
Trial Registration Number: The Norwegian Colorectal Cancer Screening trial is registered at clinicaltrials.gov (NCT00119912).
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http://dx.doi.org/10.1136/gutjnl-2014-307793 | DOI Listing |
Intern Med J
December 2024
Internal Medicine Services, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Background: Iron deficiency anaemia (IDA) related to occult gastrointestinal tract (GIT) blood loss is associated with high rates of GIT malignancies. Major society guidelines recommend bidirectional endoscopic evaluation for all men and post-menopausal women with newly diagnosed, unexplained IDA. However, in patients prescribed direct oral anticoagulants (DOACs), the endoscopic yield, specifically the rate of high-risk findings, including colorectal cancers (CRCs) and advanced adenomas (AAs), is unknown.
View Article and Find Full Text PDFZhonghua Wei Chang Wai Ke Za Zhi
December 2024
Department of Gastrointestinal Endoscopy, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou510655, China Biomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-sen University,Guangzhou510655, China.
To examine follow-up data of different subgroups in order to further evaluate the performance and practical value of community colorectal cancer screening by detection of stool methylation syndecan-2 gene (m) among residents of Shipai Town, Dongguan City. This was an observational study. From May 2021 to February 2022, the Shipai Town government of Dongguan City completed screening for colorectal cancer by detection of stool m in 10,708 residents from 18 villages who had met the initial screening criteria and been selected using whole population sampling.
View Article and Find Full Text PDFBackground: Efforts to improve colonoscopy have recently focused on improving adenoma detection through individual interventions. We evaluated an optimized computer-assisted technique (CADopt) versus standard colonoscopy.
Methods: A prospective randomized controlled trial was conducted enrolling adults (45-80 years) undergoing elective colonoscopy.
BMC Cancer
December 2024
Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP, Brazil.
Background: Colorectal cancer (CRC) is the second leading cause of cancer death worldwide. Early detection of precursor lesions or early-stage cancer could hamper cancer development or improve survival rates. Liquid biopsy, which detects tumor biomarkers, such as mutations, in blood, is a promising avenue for cancer screening.
View Article and Find Full Text PDFClin Transl Gastroenterol
December 2024
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Objectives: The detection rate of proximal sessile serrated lesion (PSSLDR) is linked to the incidence and mortality of colorectal cancer. However, research on second forward view (SFV) examinations for PSSLDR remains limited. This first randomized controlled trial assessed the impact of the proximal SFV on the PSSLDR.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!