Risk and surveillance of individuals with colorectal polyps Journal Article


Authors: Winawer, S. J.; O'Brien, M. J.; Waye, J. D.; Kronborg, O.; Bond, J.; Fruhmorgen, P.; Sobin, L. H.; Burt, R.; Zauber, A.; Morson, B.; the WHO Collaborating Centre for the Prevention of Colorectal Cancer
Contributors: Memorial Sloan-Kettering Cancer Center Gastroenterology Service; Cohen, A.; Deschner, E.; Guglielmo, C.; Fleisher, M.; Friedman, E.; Kelsen, D. P.; Kerner, J. F.; Kurtz, R. C.; Lightdale, C. J.; Lipkin, M.; Shike, M.; Sternberg, S. S.; Urmacher, C.; Zauber, A.
Article Title: Risk and surveillance of individuals with colorectal polyps
Abstract: Since colorectal adenomas are very probably the precursors of colorectal cancer, their detection and removal should result in a decrease in the incidence and mortality from colorectal cancer. Individuals who harbour an adenoma have a 30-50% probability of having additional adenomas at that time, and a 30% probability of having additional adenomas later. Adenomas are prevalent in countries where colorectal cancer is prevalent, about two-thirds of them being tubular and the rest tubulovillous or villous. The initial management of patients with an adenoma consists in searching by colonoscopy the entire colon and removing all additional polyps. Surgical resection is required wherever there is invasive cancer with adverse histological factors. Follow-up in most patients can be after 2-4 years, earlier follow-up being reserved for patients with numerous polyps or with a polyp that had been removed piecemeal. The results of ongoing trials should provide firm guidelines for follow-up and could also be used in mathematical modelling to examine alternative strategies and to help understand the evolving patterns of appearance of new polyps. Finally, a deeper understanding of the biology and inherited and acquired genetics will help identify individuals at risk for adenomas initially and at follow-up. Nutritional factors may also provide a basis for prevention of adenomas in high-risk countries. Many of these issues are being addressed in current research.
Keywords: adult; aged; cancer risk; follow up; colorectal cancer; colorectal neoplasms; adenoma; colonoscopy; colonic polyps; polyp; middle age; human; male; female; priority journal; article
Journal Title: Bulletin of the World Health Organization
Volume: 68
Issue: 6
ISSN: 0042-9686
Publisher: WHO  
Date Published: 1990-01-01
Start Page: 789
End Page: 795
Language: English
PUBMED: 2073716
PROVIDER: scopus
PMCID: PMC2393163
DOI/URL:
Notes: Article -- Source: Scopus
Citation Impact
MSK Authors
  1. Moshe Shike
    168 Shike
  2. Alfred M Cohen
    244 Cohen
  3. Martin Fleisher
    312 Fleisher
  4. Robert C Kurtz
    196 Kurtz
  5. David P Kelsen
    538 Kelsen
  6. Ann G Zauber
    315 Zauber
  7. Sidney J Winawer
    276 Winawer
  8. Martin   Lipkin
    116 Lipkin
  9. Jon Kerner
    17 Kerner