Histological assessment of colorectal adenomas by size. Are polyps less than 10 mm in size clinically important?

Objective: To define the relative risk of malignant transformation in colorectal adenomas less than 10 mm in diameter. Design: Prospective study. Setting: District general hospital, UK. Subjects and materials: 1228 polyps detected endoscopically in 445 patients over the 10‐year period 1989–1999. Mai...

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Bibliographic Details
Published in:The European journal of surgery 2001-10, Vol.167 (10), p.777-781
Main Authors: Aldridge, Andrew J., Simson, Jay N. L.
Format: Article
Language:English
Subjects:
adenoma
Adenoma - pathology
Adult
Age Distribution
Aged
Aged, 80 and over
Biological and medical sciences
Biopsy, Needle
colonic polyp
Colonic Polyps - epidemiology
Colonic Polyps - pathology
Colonic Polyps - surgery
Colonoscopy
colorectal cancer
Colorectal Neoplasms - epidemiology
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Confidence Intervals
dysplasia
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Immunohistochemistry
Incidence
Male
Medical sciences
Middle Aged
polypectomy
Precancerous Conditions - pathology
Predictive Value of Tests
Prognosis
Prospective Studies
Risk Factors
Severity of Illness Index
Sex Distribution
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tumors
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Summary:Objective: To define the relative risk of malignant transformation in colorectal adenomas less than 10 mm in diameter. Design: Prospective study. Setting: District general hospital, UK. Subjects and materials: 1228 polyps detected endoscopically in 445 patients over the 10‐year period 1989–1999. Main outcome measures: Site, size, histological type and dysplastic grade of polyp. Results: 657 of the 1228 polyps were adenomas: 281 (43%) tubular, 339 (51%) tubulovillous and 37 (6%) villous. In the 357 adenomas less than 10 mm in diameter, 11 (3%) were severely dysplastic and 2 carcinomas were detected, though neither was less than 5 mm in size. The relative risk of malignancy or severe dysplasia in adenomas of 10 mm or more compared with those of less than 10 mm was 3.8 (p < 0.0001). Conclusions: Although severe dysplasia and malignancy do occur in adenomas less than 10 mm in size, they are rare in lesions of less than 5 mm. We recommend routine destruction of all polyps 5 mm or more in size, though it is not essential to remove those of less than 5 mm if they are kept under surveillance. Copyright © 2001 Taylor and Francis Ltd.
ISSN:1102-4151
1741-9271
DOI:10.1080/11024150152707770