Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 August 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Risk factors for advanced colonic neoplasia within subcentimetric polyps

The latest issue of Gut identifies risk factors for advanced neoplasia within subcentimetric polyps, and investigates implications for diagnostic imaging.

News image

Diagnostic imaging by CT colonography and capsule endoscopy is used to detect colonic lesions.

Controversy exists regarding the work-up of subcentimetric lesions.

Dr Frank Thomas Kollig and colleagues from Germany identified risk indicators for advanced neoplasia in subcentimetric polyps.

The research team classified colonoscopies on the basis of the largest lesion found.

The team defined advanced neoplasia as high-grade dysplasia, villous histology, or cancer.

A risk index based on the logistic regression was generated, and the number needed to screen to detect advanced neoplasia was determined.

The team of doctors identified 1,077,956 colonoscopies, of which 106,270 were intermediate, and 198,954 were diminutive lesions.

The team found that 13% of intermediate, and 4% of diminutive lesions contained advanced neoplasia.

The risk of advanced neoplasia was higher in intermediate than in diminutive lesions.

Age 85 versus 45 years was associated with odds ratios of 2.4 for intermediate polyps, and 3.2 for diminutive polyps.

At median risk index values, the number needed to screen was 9.3 with intermediate lesions
Gut

The research team assessed that pedunculated versus sessile morphology was associated with a higher risk of advanced neoplasia in intermediate and diminutive lesions.

In the combined analysis for subcentimetric lesions, odds ratios were 2.7 for age 85 versus 45 years, 1.1 for male sex, 1.6 for occult blood, 1.3 for overt blood in stool, 1.3 for more than four lesions, and 2.2 for pedunculated versus sessile lesions.

The team of doctors found that at median risk index values, the number needed to screen was 9.3 in individuals with intermediate lesions, and 29.4 in those with diminutive lesions.

Compared with the number needed to screen of 15 of the whole cohort, the majority of intermediate, but a minority of diminutive, lesions were deemed at high risk of advanced neoplasia.

Dr Thomas's team concluded, "This study successfully identified risk factors and established a risk index for subcentimetric lesions."

"This has implications for the work-up of patients with subcentimetric lesions identified on diagnostic imaging."

Gut 2013; 62: 863-870
16 May 2013

Go to top of page Email this page Email this page to a colleague

 25 August 2016 
Short-chain fatty acids in mixed refractory constipation
 25 August 2016 
Stool DNA test for colorectal cancer screening
 25 August 2016 
Post-infectious IBS in C. diff
 24 August 2016 
Hep B after infant vaccination program
 24 August 2016 
Obeticholic acid for primary biliary cholangitis
 24 August 2016 
Genetics and therapy response in IBD
 23 August 2016 
Colorectal cancer genetics as biomarkers
 23 August 2016 
Prognostic test for mortality after liver transplant
 23 August 2016 
Postoperative mortality in elderly with IBD
 22 August 2016 
Celiac disease in the elderly
 22 August 2016 
Laparoscopic vs open colectomy databases
 22 August 2016 
Mucosal healing and ulcerative colitis outcomes
 19 August 2016 
Dietary questionnaire for GI clinics
 19 August 2016 
Botox treatment for chronic anal fissure
 19 August 2016 
Myeloid-derived suppressor cells in GI cancers
 18 August 2016 
Gallstone formation determinants
 18 August 2016 
Age disparities in IBD therapy
 18 August 2016 
Seasonal variation in diverticulitis
 17 August 2016 
IBD activity score for routine clinical use
 17 August 2016 
Attitudes to H. pylori in primary care
 17 August 2016 
Nonselective β-blockers and mortality in cirrhosis
 16 August 2016 
Upper GI lesions in adults with IBD
 16 August 2016 
C. difficile infection and mortality when managed by GI surgeons
 16 August 2016 
HCV eradication in cirrhosis
 15 August 2016 
Predicting favorable outcomes in IBD
 15 August 2016 
Scoring system predicted microscopic colitis
 15 August 2016 
Mortality in spontaneous bacterial peritonitis
 12 August 2016 
Recurrence of resected gastric cancer
 12 August 2016 
Screening for pancreatic cancer
 12 August 2016 
Index for diagnostic accuracy of Crohn's
 11 August 2016 
Colorectal neoplasm on surveillance colonoscopies
 11 August 2016 
Bowel disease in primary care patients with bowel symptoms
 11 August 2016 
Diagnosis in covert hepatic encephalopathy
 10 August 2016 
Maintenance therapy for children with eosinophilic esophagitis
 10 August 2016 
Moderate alcohol use and insulin action in HCV
 10 August 2016 
Consensus on the management of GERD
 09 August 2016 
Pancreatitis quality of life instrument
 09 August 2016 
Gallstone disease and NAFLD
 09 August 2016 
Steroid dependency and IBD
 08 August 2016 
Venous thromboembolism in celiac disease
 08 August 2016 
C. diff in IBD 
 08 August 2016 
Gut-directed hypnotherapy vs low FODMAP diet in IBS
 05 August 2016 
Therapy for H.pylori treatment
 05 August 2016 
Obesity and the development of NAFLD
 05 August 2016 
Obesity and CVD in celiac disease
 04 August 2016 
Bleeding after endoscopic resection of colorectal lesions
 04 August 2016 
Novel risk factor for post-ERCP pancreatitis
 04 August 2016 
Ondansetron for children with acute gastroenteritis
 03 August 2016 
Post-colonoscopy complications
 03 August 2016 
IVF in women with IBD
 03 August 2016 
Post-operative pancreatic fistulae after pancreatic surgery
 02 August 2016 
H. pylori in children
 02 August 2016 
Gastric cancer in patients with gastric intestinal metaplasia
 02 August 2016 
Behavioral changes and bariatric surgery
 01 August 2016 
Relapse after cessation of oral antiviral treatment in Hep B
 01 August 2016 
Antimicrobial resistance of H. pylori
 01 August 2016 
Colorectal cancers in IBD
 29 July 2016 
Susceptibility loci for gallstone disease
 29 July 2016 
H. pylori clarithromycin resistance in the USA
 29 July 2016 
Tool to diagnose Helicobacter-negative gastritis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us