Colon Polyp Surveillance

Andrew Catanzaro; Amitabh Chak; Harry Reynolds

doi:10.1055/s-2002-32061

Clinics in Colon and Rectal Surgery, Table of Contents

Clin Colon Rectal Surg 2002; 15(2): 131-138
DOI: 10.1055/s-2002-32061

Colon Polyp Surveillance

Andrew Catanzaro¹ , Amitabh Chak¹ , Harry Reynolds²

¹Division of Gastroenterology, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, OH
²Division of Surgery,University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, OH

Abstract

ABSTRACT

Colorectal cancer is the second leading cause of cancer-related death in the United States. Screening and surveillance for colorectal cancer are becoming more widespread, which accounts for the decreased incidence of colorectal cancer in the last decade. Endoscopic resection of adenomatous polyps has been shown to significantly decrease the incidence of colorectal cancer. The follow-up of patients after removal of adenomatous polyps is imperative as many of these patients still have a significant risk of developing colorectal cancer. For patients with adenomas found on an index colonoscopy, a repeat examination should be performed in 3 years. The age of the patient, number of polyps discovered, size of the polyps, family history, and histology of polyps are all important factors in defining the surveillance interval. In patients with numerous polyps, large polyps, and malignant polyps the surveillance interval should be less than 3 years. Surveillance programs need to be individualized to patients' underlying medical conditions and risk of colorectal cancer.

KEYWORDS

Colon polyps - colorectal cancer - adenomas - surveillance guidelines

Full Text

References

REFERENCES

1 Wingo P A, Tong T, Bolden S. 1995; 45 8-30
2 Nelson R L, Persky V. The rise and fall of colorectal cancer (letter). Dis Colon Rectum . 1994; 37 1175-1176
3 National Cancer Institute. Cancer statistics review 1973- 1987 Publication No. 90-2789. Bethesda, MD: National Institutes of Health; 1990
4 Falterman K W, Hill C B, Markely D C. Cancer of the colon, rectum, and anus: a review of 2313 cases. Cancer . 1974; 34 951
5 Konishi F, Morson B C. Pathology of colorectal adenomas: a colonoscopic survey. J Clin Pathol . 1982; 35 830-841
6 Williams A R, Balasooriya B AW, Day D W. Polyps and cancer of the large bowel: a necropsy study in Liverpool. Gut . 1982; 123 835-842
7 Muto T, Bussey H J, Morson B C. The evolution of cancer of the colon and rectum. Cancer . 1975; 36 2251-2270
8 Atkin W S, Morson B C, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med . 1992; 326 658-662
9 Stryker S J, Wolff B G, Culp C E. Natural history of untreated colonic polyps. Gastroenterology . 1987; 93 1009-1013
10 O'Brien M J, Winawer S J, Zauber A G. The National Polyp Study: patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterology . 1990; 98 371-379
11 Vogelstein B, Fearon E R, Hamilton S R. Genetic alterations during colorectal tumor development. N Engl J Med . 1988; 319 525-532
12 Muller A D, Sonnenberg A. Prevention of colorectal cancer by flexible endoscopy and polypectomy. A case-control study of 32,702 veterans. Ann Intern Med . 1995; 123 904-910
13 Winawer S J, Zauber A G, Ho M N. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med . 1993; 329 1977-1981
14 Fenoglio C M, Pascal R R. Colorectal adenomas and cancer: pathologic relationships. Cancer . 1982; 50 2061-2608
15 Day D W, Morson B C. Pathology of adenomas in the pathogenesis of colorectal cancer. In: Morson BC, ed. Major Problems in Pathology Philadelphia, PA: WB Saunders 1978: 43-57
16 Cooper H S. Surgical pathology of endoscopically malignant polyps of the colon and rectum. Am J Surg Pathol . 1983; 7 613-623
17 Winawer S J, Zauber A G, Ho M N. The National Polyp Study. 1. Design, methods, and characteristics of patients with newly diagnosed polyps. The National Polyp Study Workgroup. Cancer . 1992; 1236-1245
18 Grossman S, Milos M L, Tekawa I S, Jewell N P. Colonoscopic screening of persons with suspected risk factors for colon cancer. II. Past history of colorectal neoplasms. Gastroenterology . 1989; 96 299-306
19 Tripp M R, Morgan T R, Sampliner R E. Synchronous neoplasms in patients with diminutive colorectal adenomas. Cancer . 1987; 60 1599-1603
20 Muto T, Bussey H JR, Morson B C. The evolution of cancer of the colon and rectum. Cancer . 1975; 36 2251-2270
21 Hoff G, Foerster A, Vatn M H. Epidemiology of polyps in the rectum and colon. Recovery and evaluation of unresected polyps 2 years after detection. Scand J Gastroenterol . 1986; 21 853-862
22 Stryker S J, Wolff B G, Culp C E. Natural history of untreated colonic polyps. Gastroenterology . 1987; 93 1009-10013
23 National Polyp Study Workgroup, Winawer S J, Zauber A. The National Polyp Study: temporal sequence of evolving colorectal cancer from the normal colon (abstract). Gastrointest Endosc . 1987; 33 167
24 Waye J D, Lewis B S, Frankel A, Geller S A. Small colonic polyps. Am J Gastroenterol . 1988; 83 120-122
25 Rex D K, Smith J J, Ulbright T M, Lehman G A. Distal colonic hyperplastic polyps do not predict proximal adenomas in asymptomatic average-risk subjects. Gastroenterology . 1992; 102 317-319
26 Sciallero S, Constantini M, Bertinelli E. Distal hyperplastic polyps do not predict proximal adenomas. Gastrointest Endosc . 1997; 46 124-130
27 Brady P G, Straker R J, McClave S A. Are hyperplastic rectosigmoid polyps associated with an increased risk of proximal colonic neoplasms?. Gastrointest Endosc . 1993; 39 481-485
28 Urbanski R J, Kossakowska A E, Marcon N, Bruce W R. Mixed hyperplastic adenomatous polyps-an underdiagnosed entity. Am J Surg Pathol . 1984; 8 551-556
29 Waye J D, Braunfeld S F. Surveillance intervals after colonoscopic polypectomy. Endoscopy . 1982; 14 79-81
30 Macrae F A, Williams C B. A prospective colonoscopic follow-up study of 500 adenoma patients with multivariate analysis to predict risk of subsequent colorectal tumors (abstract). Gastroenterology . 1982; 82 A1122
31 Aubert H, Treille C, Faure H. Interet de la surveillance des malades polypectomises dan de prevention du cancer rectocolique: a propos de 123 cas. Gastroenterol Clin Biol . 1982; 6 183-187
32 Winawer S J, Zauber A G, O'Brien M J. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. N Engl J Med . 1993; 328 901-906
33 Blumberg D, Opelka F G, Hicks T C, Timmcke A E, Beck D E. The significance of normal surveillance colonoscopy in patients with a history of adenomatous polyps. Dis Colon Rectum . 2000; 43 1084-1092
34 Atkin W S, Morson B C, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med . 1992; 326 658-662
35 Winawer S J, Zauber A G, Gerdes H. Risk of colorectal cancer in the families of patients with adenomatous polyps. N Engl J Med . 1996; 334 82-87
36 Winawer S J, Zauber A G, Bishop D T. Family history of colorectal cancer as a predictor of adenomas at follow-up colonoscopy: a study based on segregation analysis (abstract). Gastroenterology . 1993; 104 462
37 Hogan W J, Stewart E T, Geenen J E. A prospective comparison of the accuracy of colonoscopy versus air-barium contrast enema for detection of colonic polypoid lesions (abstract). Gastrointest Endosc . 1977; 23 230
38 Winawer S J, Stewart E T, Zauber A G. A comparison of colonoscopy and double-contrast barium enema for surveillance after polypectomy. N Engl J Med . 2000; 342 1766-1772
39 Winawer S J, Zauber A G, Ho M N. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med . 1993; 329 1977-1981
40 Miller A, Sonnenberg A. Prevention of colorectal cancer by flexible endoscopy and polypectomy: a case-control study of 32,702 veterans. Ann Intern Med . 1995; 123 904-910
41 Rankin G B. Indications, contraindications and complications of colonoscopy. In: Sivak MV, ed. Gastrointestinal Endoscopy Philadelphia: WB Saunders 1987: 873-878
42 Bond J H, Levitt M D. Colonic gas explosion: is a fire extinguisher necessary?. Gastroenterology . 1979; 77 1349-1350
43 Waye J D, Bashkoff E. Total colonoscopy: is it always possible?. Gastrointest Endosc . 1991; 37 152-154
44 Hixson L J, Fennerty M B, Sampliner R E, Garewal H S. Prospective blinded trial of the colonoscopic miss-rate of large colorectal polyps. Gastrointest Endosc . 1991; 37 125-127
45 Rex D K, Cutler S C, Lemmel G T. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology . 1997; 112 24-28
46 Winawer S J, Fletcher R H, Bond J H. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology . 1997; 112 594-642
47 Noshirwani K, van Stolk R, Rybicki L. Adenoma size and number are predictive of adenoma recurrence: implications for surveillance colonoscopy. Gastrointest Endosc . 2000; 51 433-437
48 van Stolk R, Beck G, Baron J. Adenoma characteristics at first colonoscopy as predictors of adenoma recurrence and characteristics at follow up. Gastroenterology . 1998; 115 13-18
49 Ransohoff D, Lang C, Kuo H S. Colonoscopic surveillance after polypectomy: considerations of cost effectiveness. Ann Intern Med . 1991; 114 177-182
50 Binmoeller K F, Bohnacker S, Seifert H. Endoscopic snare excision of ``giant'' colorectal polyps. Gastrointest Endosc . 1996; 43 183-188
51 Nivatvongs S, Goldberg S. Management of patients who have polyps containing invasive carcinoma removed via colonoscope. Dis Colon Rectum . 1978; 21 8-11
52 Fenoglio C, Kaye G, Lane N. Distribution of human colonic lymphatics in normal, hyperplastic, and adenomatous tissue: its relationship to metastasis from small carcinomas in pedunculated adenomas, with two case reports. Gastroenterology . 1973; 64 51-66
53 Cranley J P, Petras R, Carey W, Paradis K, Sivak M V. When is endoscopic polypectomy adequate therapy for colonic polyps containing invasive carcinoma?. Gastroenterology . 1986; 91 419-427
54 Coutsoftodes T, Sivak Jr V M, Benjamin S P. Colonoscopy and the management of polyps containing invasive carcinoma. Ann Surg . 1978; 188 638-641
55 Haggitt R C, Glotzbach R E, Soffer E E, Wruble L D. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology . 1985; 89 328-326
56 Coverlizza S, Risio M, Ferrari A. Colorectal adenomas containing invasive carcinoma: pathologic assessment of lymph node metatstatic potential. Cancer . 1989; 64 1937-1947
57 Bond J H. Polyp guideline: diagnosis, treatment, and surveillance for patients with colorectal polyps. Am J Gastroenterol . 2000; 95 3053-3064