1,221 results match your criteria high-risk polyps


Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups.

Scand J Gastroenterol 2021 Sep 15:1-6. Epub 2021 Sep 15.

Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea.

Background: Polypectomy surveillance colonoscopy is recommended according to the risk stratification of initially removed polyps. This study aimed to evaluate the risk of advanced neoplasia following low-risk SSPs compared with that following LRAs and polyp-free groups.

Materials And Methods: From September 2013 to August 2017, asymptomatic Koreans aged 50-75 years who underwent surveillance colonoscopy post-baseline colonoscopy were enrolled. Read More

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September 2021

Prediction of the severity of colorectal lesion by fecal hemoglobin concentration observed during previous test in the French screening program.

World J Gastroenterol 2021 Aug;27(31):5272-5287

Site Isère & Drôme-Ardèche, Centre Régional de Coordination des Dépistages des Cancers en Auvergne-Rhône-Alpes, Meylan 38240, France.

Background: The rate of positive tests using fecal immunochemical test (FIT) does not decrease with subsequent campaigns, but the positive predictive value of advanced neoplasia significantly decreases in subsequent campaign after a first negative test. A relationship between the fecal hemoglobin concentration (Fhb) and the opportunity to detect a colorectal cancer in subsequent campaign has been shown.

Aim: To predict the severity of colorectal lesions based on Fhb measured during previous colorectal cancer screening campaign. Read More

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Cost-effectiveness analysis of different screening strategies for colorectal cancer in Guangzhou, southern China: a Markov simulation analysis based on natural community screening results.

BMJ Open 2021 09 6;11(9):e049581. Epub 2021 Sep 6.

Non-Communicable Chronic Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China.

Objectives: To evaluate the cost-effectiveness of four different primary screening strategies: high-risk factor questionnaire (HRFQ) alone, single immunochemical faecal occult blood test (iFOBT), double iFOBT and HRFQ+double iFOBT for colorectal cancer (CRC) screening compared with no screening using the Markov model.

Methods: Treeage Pro V.2011 software was used to simulate the Markov model. Read More

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September 2021

Pedunculated early colorectal cancer with nodal metastasis: a case report.

World J Surg Oncol 2021 Sep 3;19(1):269. Epub 2021 Sep 3.

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan.

Background: Pedunculated polyps are more likely to be amenable to complete resection than non-pedunculated early colorectal cancers and rarely require additional surgery. We encountered a patient with a pedunculated early colorectal cancer that consisted of poorly differentiated adenocarcinoma with lymphatic invasion. We performed an additional bowel resection and found nodal metastasis. Read More

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September 2021

Importance of sessile serrated lesions in a patient with familial adenomatous polyposis.

Clin J Gastroenterol 2021 Aug 29. Epub 2021 Aug 29.

Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.

A 28-year-old male visited hospital because his mother had been diagnosed with familial adenomatous polyposis (FAP) with a pathological variant of the APC gene. Total colonoscopy showed that he has more than 100 polyps distributed throughout the colorectum, and the APC gene variant was also detected. After he was diagnosed with FAP, he received information that surgery was currently the only way to prevent the development of colorectal cancer. Read More

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Double intussusception in a teenage child with Peutz-Jeghers syndrome: A case report.

World J Clin Cases 2021 Aug;9(23):6804-6809

Department of Surgery, Hospital Sultanah Aminah, Johor Bahru 80100, Malaysia.

Background: Peutz-Jeghers syndrome (PJS) is a genetic disorder characterized by the development of gastrointestinal hamartomatous polyps and mucocutaneous melanin pigmentation. Patients with PJS are at risk of complications such as intussusception. Intussusception is a condition where one segment of the intestine invaginates into another, causing intestinal obstruction. Read More

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Intensive surveillance endoscopy for multiple gastrointestinal tumors in a patient with constitutional mismatch repair deficiency: case report.

BMC Gastroenterol 2021 Aug 23;21(1):326. Epub 2021 Aug 23.

Third Department of Internal Medicine, University of Toyama, 2630 Sugitani, 930-0194, Toyama, Japan.

Background: Constitutional mismatch repair deficiency (CMMRD) is an extremely rare autosomal recessive hereditary disease characterized by the absence of mismatch repair gene activity from birth, which results in brain tumors, colonic polyposis, gastrointestinal cancers, and lymphomas later in life. An aggressive approach, including colectomy or proctocolectomy, is recommended for the treatment of colorectal cancer. Additionally, partial colectomy with subsequent endoscopic surveillance may be an alternative strategy due to poor patient's condition, although there is no evidence of surveillance endoscopy after partial colectomy for CMMRD. Read More

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Long-term Use of Hormone Replacement Therapy is Associated With a Lower Risk of Developing High-risk Serrated Polyps in Women.

J Clin Gastroenterol 2021 Aug 18. Epub 2021 Aug 18.

Departments of Community Health Sciences Oncology Medicine, Cumming School of Medicine, University of Calgary Department of Cancer Epidemiology and Prevention Research, Alberta Health Services Forzani and MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, AB, Canada.

Goals/background: Hormone replacement therapy (HRT) and parity have been suggested protective factors against the development of colorectal polyps. However, there are a limited number of studies that have examined the relationship of these factors with high-risk adenomatous polyps (HRAP) or high-risk serrated polyps (HRSP), which may have different causes and therefore implications for screening programs.

Study: Data from a cross-sectional study of 1384 women undergoing screening-related colonoscopy between 2008 and 2016 were analyzed. Read More

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Fasting Plasma Glucose and Incident Colorectal Cancer: Analysis of a Nationwide Epidemiological Database.

J Clin Endocrinol Metab 2021 Jun 25. Epub 2021 Jun 25.

Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.

Context: Although diabetes mellitus (DM) was reported to be associated with incident colorectal cancer (CRC), the detailed association between fasting plasma glucose (FPG) and incident CRC has not been fully understood.

Objective: We assessed whether hyperglycemia is associated with a higher risk for CRC.

Design: Analyses were conducted using the JMDC Claims Database [n = 1 441 311; median age (interquartile range), 46 (40-54) years; 56. Read More

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Evaluation of global and intragenic hypomethylation in colorectal adenomas improves patient stratification and colorectal cancer risk prediction.

Clin Epigenetics 2021 Aug 9;13(1):154. Epub 2021 Aug 9.

Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Background: Aberrant DNA hypomethylation of the long interspersed nuclear elements (LINE-1 or L1) has been recognized as an early event of colorectal transformation. Simultaneous genetic and epigenetic analysis of colorectal adenomas may be an effective and rapid strategy to identify key biological features leading to accelerated colorectal tumorigenesis. In particular, global and/or intragenic LINE-1 hypomethylation of adenomas may represent a helpful tool for improving colorectal cancer (CRC) risk stratification of patients after surgical removal of polyps. Read More

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Use of Artificial Intelligence to Improve the Quality Control of Gastrointestinal Endoscopy.

Front Med (Lausanne) 2021 22;8:709347. Epub 2021 Jul 22.

Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, China.

With the rapid development of science and technology, artificial intelligence (AI) systems are becoming ubiquitous, and their utility in gastroenteroscopy is beginning to be recognized. Digestive endoscopy is a conventional and reliable method of examining and diagnosing digestive tract diseases. However, with the increase in the number and types of endoscopy, problems such as a lack of skilled endoscopists and difference in the professional skill of doctors with different degrees of experience have become increasingly apparent. Read More

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A Pilot Study Investigating the Expression Levels of Pluripotency-Associated Genes in Rectal Swab Samples for Colorectal Polyp and Cancer Diagnosis and Prognosis.

Stem Cells Int 2021 22;2021:4139528. Epub 2021 Jul 22.

Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

Change in gene expression is inevitable in cancer development. With more studies demonstrating the contributions of cancer stem cells (CSCs) in colorectal cancer (CRC) development, this study is aimed at investigating whether rectal swab specimen serves as a tool for detection of dysregulation of CSC or stem cell (SC) markers and at evaluating its potential as a new promising screening method for high-risk patients. Expression levels of 15 pluripotency-associated genes were assessed by quantitative PCR in 53 rectal swab specimens referred for endoscopic screening. Read More

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Development of a narrow-band imaging classification to reduce the need for routine biopsies of gastric polyps.

Gastroenterol Rep (Oxf) 2021 Jun 27;9(3):219-225. Epub 2020 Dec 27.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Background: Most incidental gastric polyps identified during upper endoscopy are considered low-risk. However, current guidelines recommend sampling all gastric polyps for histopathologic analysis. We aimed to devise a simple narrow-band imaging (NBI) classification to reduce the need for routine biopsies of low-risk gastric polyps. Read More

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Incidence and risk factors of colorectal delayed post-polypectomy bleeding in patients taking antithrombotics.

J Dig Dis 2021 Aug;22(8):481-487

Department of Gastroenterology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Objective: In this study we aimed to investigate the incidence and risk factors for delayed post-polypectomy bleeding (DPPB) in Chinese patients taking antithrombotics including antiplatelet agents and anticoagulants.

Methods: A retrospective study was conducted in patients who underwent colorectal polypectomy from January 2017 to May 2020. Their demographic characteristics, features of the polyps including number, size, morphology, and location, and use of antiplatelet agents and anticoagulants were collected. Read More

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WNT2 activation through proximal germline deletion predisposes to small intestinal neuroendocrine tumors and intestinal adenocarcinomas.

Hum Mol Genet 2021 Jul 19. Epub 2021 Jul 19.

Department of Medical and Clinical Genetics, Faculty of Medicine, University of Helsinki, FI-00014 Helsinki, Finland.

Many hereditary cancer syndromes are associated with an increased risk of small and large intestinal adenocarcinomas. However, conditions bearing a high risk to both adenocarcinomas and neuroendocrine tumors are yet to be described. We studied a family with 16 individuals in four generations affected by a wide spectrum of intestinal tumors, including hyperplastic polyps, adenomas, small intestinal neuroendocrine tumors, and colorectal and small intestinal adenocarcinomas. Read More

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RNA-sequencing identification and validation of genes differentially expressed in high-risk adenoma, advanced colorectal cancer, and normal controls.

Funct Integr Genomics 2021 Jul 17;21(3-4):513-521. Epub 2021 Jul 17.

Department of Pathology, College of Medicine, Korea University, Seoul, Republic of Korea.

Distinct gene expression patterns that occur during the adenoma-carcinoma sequence need to be determined to analyze the underlying mechanism in each step of colorectal cancer progression. Elucidation of biomarkers for colorectal polyps that harbor malignancy potential is important for prevention of colorectal cancer. Here, we use RNA sequencing to determine gene expression profile in patients with high-risk adenoma treated with endoscopic submucosal dissection by comparing with gene expression in patients with advanced colorectal cancer and normal controls. Read More

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Changes in Lifestyle Factors After Endoscopic Screening: A Prospective Study in the United States.

Clin Gastroenterol Hepatol 2021 Jul 10. Epub 2021 Jul 10.

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:

Background: Endoscopic screening and adherence to a healthy lifestyle are major avenues for colorectal cancer (CRC) prevention. We investigated changes in lifestyles after endoscopic screening.

Methods: We drew data from 76,303 pairs of time- and age-matched individuals who had and had not, respectively, reported first time endoscopic screening, in the 3 cohorts (Nurses' Health Study I and II and the Health Professionals Follow-up Study). Read More

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A pilot study for colorectal carcinoma screening by instant metabolomic profiles using conductive polymer spray ionization mass spectrometry.

Biochim Biophys Acta Mol Basis Dis 2021 Nov 9;1867(11):166210. Epub 2021 Jul 9.

Department of Pharmacy, Beijing Hospital, Beijing 100730, China; National Center of Gerontology, Beijing 100730, China; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China; Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application (Beijing Hospital), Beijing 100730, China. Electronic address:

Background: The rapid and accurate discrimination of colorectal carcinoma (CRC) and polyps at the molecular level enables early intervention of CRC, which can greatly improve the 5-year survival rate of patients. Here we reported the potential of conductive polymer spray ionization mass spectrometry (CPSI-MS) in successfully screening CRC according to the serum metabolic profile.

Methods: Trace intravenous blood (50 μL) was collected from 60 colorectal carcinoma (CRC) and 60 polyp patients, respectively. Read More

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November 2021

mutation induces rapid neoplastic transformation in the aged and aberrantly methylated intestinal epithelium.

Gut 2021 Jul 6. Epub 2021 Jul 6.

The Conjoint Gastroenterology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.

Objective: Sessile serrated lesions (SSLs) are common across the age spectrum, but the mutant cancers arising occur predominantly in the elderly. Aberrant DNA methylation is uncommon in SSL from young patients. Here, we interrogate the role of ageing and DNA methylation in SSL initiation and progression. Read More

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Practice Patterns and Predictors of Stopping Colonoscopy in Older Adults With Colorectal Polyps.

Clin Gastroenterol Hepatol 2021 Jun 30. Epub 2021 Jun 30.

Dartmouth's Geisel School of Medicine, Hanover, New Hampshire; Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Electronic address:

Background & Aims: Older adults with colorectal polyps undergo frequent surveillance colonoscopy. There is no specific guidance regarding when to stop surveillance. We aimed to characterize endoscopist recommendations regarding surveillance colonoscopy in older adults and identify patient, procedure, and endoscopist characteristics associated with recommendations to stop. Read More

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Risk of Pre-Malignancy or Malignancy in Postmenopausal Endometrial Polyps: A CHAID Decision Tree Analysis.

Diagnostics (Basel) 2021 Jun 15;11(6). Epub 2021 Jun 15.

Institute for Women's Health, University College London Hospitals, London NW1 2BU, UK.

Background And Aims: Postmenopausal endometrial polyps are commonly managed by surgical resection; however, expectant management may be considered for some women due to the presence of medical co-morbidities, failed hysteroscopies or patient's preference. This study aimed to identify patient characteristics and ultrasound morphological features of polyps that could aid in the prediction of underlying pre-malignancy or malignancy in postmenopausal polyps.

Methods: Women with consecutive postmenopausal polyps diagnosed on ultrasound and removed surgically were recruited between October 2015 to October 2018 prospectively. Read More

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What is the impact of CT colonography interpretation by advanced practitioner radiographers on delivery of the 28 day colorectal cancer target?

Radiography (Lond) 2021 Jun 24. Epub 2021 Jun 24.

Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom. Electronic address:

Introduction: CT Colonography (CTC) is an indicated test to assess the colon and rectum for evidence of polyps and neoplasms. The advanced practitioner radiographer (APR) is increasingly involved with the entirety of the radiology pathway including procedural modification, preliminary clinical evaluation (PCE) and multi-disciplinary team (MDT) meeting notification of high risk colonic pathologies.

Methods: A retrospective audit of the Radiology Information System (RIS) was undertaken at a large secondary care centre, 12 months of data of 119 consecutive patients who had undergone CTC with summary coded reports of high risk pathology were included for analysis. Read More

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Fasting Plasma Glucose and Incident Colorectal Cancer: Analysis of a Nationwide Epidemiological Database Fasting Plasma Glucose and Colorectal Cancer.

J Clin Endocrinol Metab 2021 Jun 25. Epub 2021 Jun 25.

The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.

Context: Although diabetes mellitus (DM) was reported to be associated with incident colorectal cancer (CRC), the detailed association between fasting plasma glucose (FPG) and incident CRC has not been fully understood.

Objective: We assessed whether hyperglycemia is associated with a higher risk for CRC.

Design: Analyses were conducted using the JMDC Claims Database (n=1,441,311; median age [IQR], 46 [40-54] years; 56. Read More

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Early colorectal cancer detection-Current and evolving challenges in evidence, guidelines, policy, and practices.

Adv Cancer Res 2021 22;151:69-107. Epub 2021 Apr 22.

Surveillance Research, Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, GA, United States.

The understanding at the beginning of the last century that colorectal cancer began as a localized disease that progressed and became systemic, and that most colorectal cancer arose from adenomatous polyps gave rise to aggressive attempts at curative treatment and eventually attempts to detect advanced lesions before they progressed to invasive disease. In the last four decades, steadily greater uptake of screening has led to reductions in colorectal cancer incidence and mortality. However, the fullest potential of screening is not being met due to the lack of organized screening, where a systems approach could lead to higher rates of screening of average and high risk groups, higher quality screening, and prompt followup of adults with positive screening tests. Read More

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Scoring system for gallbladder polyps based on the cross-sectional area and patient characteristics.

Asian J Surg 2021 Jun 16. Epub 2021 Jun 16.

Department of Hepatological Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address:

Background: Current management guidelines for gallbladder polyps (GBPs) focus on a diameter more than 1 cm as an indication for cholecystectomy. Since most GBPs are not malignant, unnecessary cholecystectomies can lead to unnecessary complications and costs. We developed a score to identify true polyps focusing on their cross-sectional area (CSA). Read More

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SMAD4 Germline Pathogenic Variant-Related Gastric Juvenile Polyposis with Adenocarcinoma Treated with Laparoscopic Total Gastrectomy: A Case Report.

Am J Case Rep 2021 Jun 18;22:e932241. Epub 2021 Jun 18.

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

BACKGROUND Juvenile polyposis syndrome is an uncommon, autosomal-dominant hereditary disease that is distinguished by multiple polyps in the stomach or intestinal tract. It is associated with a high risk of malignancy. Pathogenic variants in SMAD4 or BMPR1A account for 40% of all cases. Read More

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Will a flexi-sig' do? A retrospective review of colonoscopies indicated by diverticulitis alone.

Surg Endosc 2021 Jun 10. Epub 2021 Jun 10.

Dept. General Surgery, Caboolture Hospital, 97/120 McKean Street, Caboolture, QLD, 4510, Australia.

Background: The incidence of colonic diverticulitis is increasing. In Australia the majority of diverticulitis occurs in the left colon and patients typically undergo colonoscopy following an attack. At present debate exists regarding the utility of this costly procedure and a flexible sigmoidoscopy has been proposed as a cheaper, less invasive alternative. Read More

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Laparoscopic wedge resection as an alternative to laparoscopic oncological colon resection for benign endoscopically unresectable colon polyps.

Colorectal Dis 2021 Sep 29;23(9):2361-2367. Epub 2021 Jun 29.

Department of Surgery, Flevoziekenhuis, Almere, The Netherlands.

Aim: The aim of this study was to investigate, by comparing clinical and histological outcomes, whether laparoscopic (hybrid) wedge resection (LWR) could be a less invasive and safe alternative to laparoscopic oncological colon resection (OCR) for patients with an endoscopically unresectable, suspected benign, colon polyp.

Method: All patients with an endoscopically unresectable colon polyp who were referred for surgery between 2009 and 2018 and without biopsy-proven colon cancer were identified from a prospectively maintained database. Patients with macroscopic features of malignancy during endoscopy were excluded. Read More

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September 2021

Short and long-term psychosocial consequences of participating in a colorectal cancer screening programme: a matched longitudinal study.

BMJ Evid Based Med 2021 Jun 3. Epub 2021 Jun 3.

The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark.

Objectives: To investigate the psychosocial consequences of receiving a false-positive (no abnormalities) result or being diagnosed with polyps compared with receiving a negative result in a colorectal cancer (CRC) screening programme.

Design And Setting: This was a longitudinal study nested in the roll-out of the Danish CRC screening programme that targets all individuals aged 50-74 years.

Participants: In the inclusion period (April-September 2017), all positive screenees (n=1854) were consecutively enrolled and matched 2:1:1 on sex, age (±2 years), municipality and screening date with negative screenees (n=933) and individuals not yet invited to screening (n=933). Read More

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Post-polypectomy surveillance colonoscopy: Comparison of the updated guidelines.

United European Gastroenterol J 2021 Jul 2;9(6):681-687. Epub 2021 Jun 2.

Department of Gastroenterology, Beilinson Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Recently, three updated guidelines for post-polypectomy colonoscopy surveillance (PPCS) have been published. These guidelines are based on a comprehensive summary of the literature, while some recommendations are similar, different surveillance intervals are recommended after detection of specific types of polyps.

Aim: In this review, we aimed to compare and contrast these recommendations. Read More

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