Ampullary Adenomas Are Associated With Increased Colorectal Neoplasia Risk
Douglas K. Rex, MD, MASGE, reviewing Zhou F, et al. Dig Liver Dis 2022 Nov 18.
Nonampullary adenomas are frequently associated with an increased risk of colorectal adenomas. There is less known about the association between ampullary adenomas and colorectal neoplasia.
In a single-center study, there were 95 patients with sporadic ampullary adenomas who underwent colonoscopy 1 year before or after diagnosis, with results compared with those of 380 matched asymptomatic controls. Colorectal polyps were found in 60% of cases as opposed to only 34.7% of controls (P=.001). The patients with ampullary adenomas were more likely to have advanced colorectal adenomas (20% vs 5.5%) and numerically more colorectal adenocarcinomas (4.2% vs 0.8%). There was no difference in colorectal polyp location or histology between the groups, but patients with ampullary adenomas had larger colorectal adenomas (P<.001).
COMMENTAlthough there are clear opportunities for error in studies of this type, these data indicate that patients with sporadic ampullary adenomas should undergo screening colonoscopy. This recommendation is also commonly made for patients with sporadic nonampullary adenomas.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Zhou F, He L, Xie Y, et al. High frequency of colorectal neoplasia in patients with sporadic adenomas or adenocarcinomas of the papilla of Vater: the same adenoma-carcinoma sequence? Dig Liver Dis 2022 Nov 18. (Epub ahead of print) (https://doi.org/10.1016/j.dld.2022.10.022)
