Help
Subscribe


Submit Videos to GastroHep 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

 28 November 2014

Advanced search
 28 November 2014 
C. diff and pediatric IBD
 28 November 2014 
Fruit and vegetable consumption and esophageal cancer
 28 November 2014 
IBD and students' adjustment to college
 27 November 2014 
Prediction of functional GI disorders later in life
 27 November 2014 
Differences in the incidence of esophageal adenocarcinoma
 27 November 2014 
End points of outcomes in primary biliary cirrhosis
 26 November 2014 
Detection of gastric precancerous conditions
 26 November 2014 
Vegetables and garlic and colorectal cancer risk
 26 November 2014 
Fertility in women with celiac disease
 25 November 2014 
Esophagogastric junction of children with GERD
 25 November 2014 
Symptom activity index for eosinophilic esophagitis
 25 November 2014 
Placebo response rate in fistulizing Crohn's
 24 November 2014 
Nasoenteric tube feeding in acute pancreatitis
 24 November 2014 
Corticosteroids and infections in elderly-onset IBD
 24 November 2014 
Adhesions in abdominal and pelvic surgery
 21 November 2014 
Hepatic involvement in IgG4-related disease
 21 November 2014 
Mortality of chemoembolization in hepatocellular carcinoma
 21 November 2014 
Skin cancer in ulcerative colitis patients
 20 November 2014 
Global measures in chronic idiopathic constipation
 20 November 2014 
Macrophage activation in alcoholic hepatitis
 20 November 2014 
Covert hepatic encephalopathy and survival
 19 November 2014 
Thiopurine withdrawal in IBD
 19 November 2014 
Esophageal narrowing in esophageal eosinophilia
 19 November 2014 
Second intestinal resection in Crohn's
 18 November 2014 
Colorectal neoplasia and vitamin D
 18 November 2014 
Food-associated changes in the intestinal mucosa in IBS
 18 November 2014 
Alternative medicine use by US adults
 17 November 2014 
Allergy-related diseases and abdominal pain in childhood
 17 November 2014 
Treatment of obesity in primary care settings
 17 November 2014 
Diagnosis of monogenic very early onset IBD
 14 November 2014 
Second intestinal resection in Crohn's
 14 November 2014 
HCC risk in active stage Hep B
 14 November 2014 
Thiopurine and clinical remission in IBD
 13 November 2014 
Antibiotics and risk of new-onset Crohn’s
 13 November 2014 
Chronic Hep C genotype 1 treatment after relapse
 13 November 2014 
Chemoembolization for hepatocellular carcinoma
 12 November 2014 
Risk of hepatocellular carcinoma
 12 November 2014 
Abdominal symptom severity in chronic idiopathic constipation
 12 November 2014 
Screening colonoscopy
 11 November 2014 
Hepatocellular carcinoma in Hep B with nucleotide analogue
 11 November 2014 
Familial colorectal cancer screening
 11 November 2014 
Fecal microbiota transplant for C. diff
 10 November 2014 
STaples IPAA for ulcerative colitis
 10 November 2014 
Blood stream infections in acute liver failure
 10 November 2014 
Ig4-related disease
 07 November 2014 
Host and viral factors in chronic Hep C
 07 November 2014 
Celiac diagnosis without biopsy
 07 November 2014 
Pricing practices of gastroenterologists
 06 November 2014 

Colorectal surgery postdischarge occurrences and readmissions

 06 November 2014 
Thromboprophylaxis in IBD
 06 November 2014 
Steatosis biomarkers in NAFLD
 05 November 2014 
Readmission risk factors for patients with IBD
 05 November 2014 
Hysterectomy and colonoscopy completion
 05 November 2014 
Adalimumab in Crohn's disease
 04 November 2014 
Gut barrier dysfunction and CNS disorders
 04 November 2014 
Hemospray for nonvariceal upper GI bleeding
 04 November 2014 
Sleep duration and ulcerative colitis
 03 November 2014 
Mucosal pathophysiology in HIV and IBD
 03 November 2014 
Managing bleeding gastroduodenal ulcers
 03 November 2014 
Identifying inflammation in ulcerative colitis

Blackwell Publishing


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