{"id":6683,"date":"2019-10-04T12:23:30","date_gmt":"2019-10-04T10:23:30","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/?post_type=ec-news&p=6683"},"modified":"2019-10-14T20:17:27","modified_gmt":"2019-10-14T18:17:27","slug":"6-to-9-mm-adenomas-again-shown-to-predict-advanced-neoplasia-versus-diminutive-adenomas","status":"publish","type":"ec-news","link":"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/6-to-9-mm-adenomas-again-shown-to-predict-advanced-neoplasia-versus-diminutive-adenomas\/","title":{"rendered":"6- to 9-mm Adenomas Again Shown to Predict Advanced Neoplasia Versus Diminutive Adenomas"},"content":{"rendered":"\n
Current postpolypectomy surveillance guidelines lump adenomas 1 to 9 mm in size together in a category of low-risk adenomas. Advanced adenomas are defined as those \u226510 mm in size or having high-grade dysplasia or villous elements.<\/p>\n\n\n\n
Several recent studies have suggested that 6- to 9-mm adenomas have more predictive value for subsequent advanced neoplasia than do diminutive (1-5 mm) adenomas. <\/p>\n\n\n\n
Another single-center study has addressed this issue. Among 2477 qualifying baseline colonoscopies with only tubular adenomas <10 mm in size, the risk of advanced neoplasia at follow-up colonoscopy was 3.6% in patients with 1- to 5-mm adenomas versus 6.9% if at least one 6- to 9-mm adenoma was present. The effect was clearer when only screening colonoscopies were considered. For screening colonoscopy, all baseline groups by number of adenomas (1-2 adenomas, 3-4 adenomas, and \u22655 adenomas) had an increased risk of metachronous advanced neoplasia if at least one of the adenomas was 6 to 9 mm in size.<\/p>\n\n\n\n
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Comment: The most recent postpolypectomy surveillance recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer were that persons with one or two tubular adenomas with low-grade dysplasia and 1 to 9 mm in size could undergo follow-up colonoscopy in 5 to 10 years. Most U.S. clinicians utilize the more conservative 5-year interval. These recent studies showing that 6- to 9-mm adenomas are associated with increased risk provide a basis for risk stratifying within the 1- to 9-mm adenoma group, perhaps using the shorter end of the recommended interval in persons with a 6- to 9-mm adenoma and the longer end in persons with only one or two diminutive adenomas. <\/p><\/blockquote><\/figure>\n\n\n\n
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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. <\/p>\n\n\n\n
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\n\nDouglas K. Rex, MD, FASGE\n\n<\/p>\n<\/div><\/div>\n\n\n\n
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