Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton 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

 01 August 2014

Advanced search
 01 August 2014 
Fully covered self-expanding metal stents for benign biliary strictures
 01 August 2014 
Capsule colonoscopy vs CT colonography for polyp screening
 01 August 2014 
Complications after obesity surgery
 31 July 2014 
Biomarkers in liver fibrosis
 31 July 2014 
Risk factors of large colorectal polyps
 31 July 2014 
Diverticular disease and colon cancer
 30 July 2014 
Interval between screening colonoscopies
 30 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 30 July 2014 
Mineral rich water and constipation
 29 July 2014 
Fluticasone in eosinophilic esophagitis
 29 July 2014 
Causes of GI bleeding in cirrhosis
 29 July 2014 
ALT increases in Hep B
 28 July 2014 
Statins reduce Barrett's
 28 July 2014 
Score predicts risk for Barrett’s esophagus
 28 July 2014 
Gastric cancer prevention
 25 July 2014 
De-escalation of therapy in IBD
 25 July 2014 
Bionic pancreas in type 1 diabetes
 25 July 2014 
Primary care physician counselling and colonoscopy
 24 July 2014 
Diagnostic tool for obscure-overt GI bleeding
 24 July 2014 
Statin use and Barrett’s esophagus
 24 July 2014 
Atopy and functional GI disorders
 23 July 2014 
Sofosbuvir and ribavirin for Hep C
 23 July 2014 
Early corticosteroids after the diagnosis of ulcerative colitis
 23 July 2014 
C-section and IBD risk
 22 July 2014 
Thromboembolism in IBD
 22 July 2014 
Alcohol and colorectal adenoma risk
 22 July 2014 
Cognitive behavioral therapy in IBS
 21 July 2014 
Stents to prevent post-ERCP pancreatitis
 21 July 2014 
Psychometric validation of IBS symptom severity
 21 July 2014 
Mortality in IBD
 18 July 2014 
Treatment of enteropancreatic neuroendocrine tumors
 18 July 2014 
Ulcer complications and dyspeptic symptoms
 18 July 2014 
ERCP with overtube-assisted enteroscopy
 17 July 2014 
Treatment of H. pylori
 17 July 2014 
Ultrasound for diagnosis of gastric varices
 17 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 16 July 2014 
Mortality after colectomy in IBD
 16 July 2014 
Esophageal cancer missed at endoscopy
 16 July 2014 
Screening for Hepatitis B
 15 July 2014 
Diagnosing diverticulitis
 15 July 2014 
Variation in management decisions for colorectal cancer
 15 July 2014 
Muscle cramps in cirrhosis
 14 July 2014 
Predicting the course of ulcerative colitis
 14 July 2014 
Choice in colorectal cancer screening tests
 14 July 2014 
Adhesions in abdominal surgery
 11 July 2014 
Temporal evolution of antidrug antibodies in IBD
 11 July 2014 
Atopy and functional gastrointestinal disorders
 11 July 2014 
Fecal microbiota transplant for C. diff
 10 July 2014 
Acid-suppressive medications and cancer risk in Barrett's
 10 July 2014 
Personalized medicine in the management of IBD
 10 July 2014 
Pregnancy outcome in anti-TNF treated women with IBD
 09 July 2014 
Quality of care provided to patients with varices
 09 July 2014 
Eosinophilic esophagitis and celiac disease
 09 July 2014 
Diagnosis and management of adult celiac disease
 08 July 2014 
Screening for Hep B
 08 July 2014 
NSAID-induced small intestinal injury
 08 July 2014 
Drug-induced liver injury
 07 July 2014 
Obesity and complications after lapaproscopic colorectal surgery
 07 July 2014 
Everolimus and advanced hepatocellular carcinoma
 07 July 2014 
Pediatric celiac disease risk factors

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us