Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Small Polyps Pose Little Risk of Colorectal Cancer Pitt Research Ran for Up to 15 Years

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Small Polyps Pose Little Risk of Colorectal Cancer Pitt Research Ran for Up to 15 Years

Article excerpt

Colorectal cancer occurs when polyps turn malignant, which explains why physicians routinely remove polyps of all sizes during a colonoscopy.

And a University of Pittsburgh study confirms that advanced polyps larger than 1 centimeter put a person at 2.5 times the risk for developing colorectal cancer as compared to someone with no polyps at all.

But, surprisingly, the study also found that people with nonadvanced polyps - polyps less than 1 centimeter - face no higher risk of colorectal cancer than people with no polyps. That finding could suggest less frequent colonoscopies for people who only have small or nonadvanced polyps.

"That's a provocative finding," said Robert E. Schoen, UPMC chief of the division of gastroenterology, hepatology and nutrition at UPMC. "It would suggest that if you have a polyp that is nonadvanced, which is the case in about 30 percent of people undergoing screening, you don't need to come back as frequently for a subsequent colonoscopy because your risk of cancer is the same as if you didn't have any polyps."

As the study concludes: "Identification of nonadvanced [polyps] may not be associated with increased colorectal cancer risk."

The study led by Dr. Schoen and published online Tuesday in the Journal of the American Medical Association followed 15,900 people for up to 15 years to define the cancer risk of people with different-sized polyps. Such research is important in guiding physicians on how frequently a patient should undergo a colonoscopy, which helps prevent and diagnose colorectal cancer but also holds potential for serious side effects.

Current U.S. guidelines recommend a colonoscopy follow-up interval of 5 to 10 years for patients with one to two nonadvanced polyps. But the decision between 5 and 10 years is often left to physician discretion and evidence-based recommendations are unavailable. Individuals whose colonoscopy shows no polyps are advised to return in 10 years.

Environmental factors in combination with genetic factors explain most cases, Dr. Schoen said. Most notably a diet of red meat that also lacks fiber has been linked to colon cancer. …

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