Hyperplastic colonic polyps as a marker for adenomatous colonic polyps

A. F. Ansher, J. H. Lewis, D. E. Fleischer, E. L. Cattau, M. J. Collen, D. A. O'Kieffe, L. Y. Korman, S. B. Benjamin

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Abstract

Hyperplastic colonic polyps are generally regarded as being of little or no clinical consequence. Recently, however, hyperplastic polyps have been found to share numerous functional similarities with colorectal carcinoma. To determine whether the presence of an isolated left-sided colonic hyperplasia (metaplastic) polyp could serve as a marker for more proximal synchronous adenomatous colonic polyps, we retrospectively analyzed all consecutive colonoscopic polypectomies performed over an 18-month period at two medical centers. It is the policy at both institutions to remove or biopsy all polyps, regardless of size. Indications for colonoscopy included known or previous colonic polyps or carcinoma, hemoccult positive stool, lower gastrointestinal bleeding, iron deficiency anemia, abnormal barium enema, inflammatory bowel disease, abdominal pain, and family history of colon cancer. The location of adenomatous polyps and hyperplastic polyps was recorded and compared. One hundred sixty-three of 845 consecutive patients (19.3%) had at least one colonic polyp. The prevalence of adenomatous polyps alone was 10.3%, hyperplastic polyps 9%, and both types 1.9%. The prevalence rate had an adenomatous polyp in patients without a hyperplastic polyp was 15%. In contrast, among patients with a hyperplastic polyp, 49% had a synchronous adenomatous poly. Only 3.4% of patients had an adenomatous polyp proximal to the splenic flexure when no polyps were present in the left colon. Conversely, among the 29 patients in whom an isolated hyperplastic polyp was found in the left colon, there was a 32.5% prevalence of adenomatous polyps in the proximal colon (p < 0.01). The results of this study suggest that left-sided hyperplastic colonic polyps (generally within the reach of a screening sigmoidoscopy) serve as a marker for neoplastic polyps.

Original languageEnglish (US)
Pages (from-to)113-117
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume84
Issue number2
StatePublished - 1989
Externally publishedYes

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Colonic Polyps
Adenomatous Polyps
Polyps
Colon
Sigmoidoscopy
Transverse Colon
Iron-Deficiency Anemias
Colonoscopy
Inflammatory Bowel Diseases
Colonic Neoplasms
Abdominal Pain
Hyperplasia
Colorectal Neoplasms

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Ansher, A. F., Lewis, J. H., Fleischer, D. E., Cattau, E. L., Collen, M. J., O'Kieffe, D. A., ... Benjamin, S. B. (1989). Hyperplastic colonic polyps as a marker for adenomatous colonic polyps. American Journal of Gastroenterology, 84(2), 113-117.

Hyperplastic colonic polyps as a marker for adenomatous colonic polyps. / Ansher, A. F.; Lewis, J. H.; Fleischer, D. E.; Cattau, E. L.; Collen, M. J.; O'Kieffe, D. A.; Korman, L. Y.; Benjamin, S. B.

In: American Journal of Gastroenterology, Vol. 84, No. 2, 1989, p. 113-117.

Research output: Contribution to journalArticle

Ansher, AF, Lewis, JH, Fleischer, DE, Cattau, EL, Collen, MJ, O'Kieffe, DA, Korman, LY & Benjamin, SB 1989, 'Hyperplastic colonic polyps as a marker for adenomatous colonic polyps', American Journal of Gastroenterology, vol. 84, no. 2, pp. 113-117.
Ansher AF, Lewis JH, Fleischer DE, Cattau EL, Collen MJ, O'Kieffe DA et al. Hyperplastic colonic polyps as a marker for adenomatous colonic polyps. American Journal of Gastroenterology. 1989;84(2):113-117.
Ansher, A. F. ; Lewis, J. H. ; Fleischer, D. E. ; Cattau, E. L. ; Collen, M. J. ; O'Kieffe, D. A. ; Korman, L. Y. ; Benjamin, S. B. / Hyperplastic colonic polyps as a marker for adenomatous colonic polyps. In: American Journal of Gastroenterology. 1989 ; Vol. 84, No. 2. pp. 113-117.
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abstract = "Hyperplastic colonic polyps are generally regarded as being of little or no clinical consequence. Recently, however, hyperplastic polyps have been found to share numerous functional similarities with colorectal carcinoma. To determine whether the presence of an isolated left-sided colonic hyperplasia (metaplastic) polyp could serve as a marker for more proximal synchronous adenomatous colonic polyps, we retrospectively analyzed all consecutive colonoscopic polypectomies performed over an 18-month period at two medical centers. It is the policy at both institutions to remove or biopsy all polyps, regardless of size. Indications for colonoscopy included known or previous colonic polyps or carcinoma, hemoccult positive stool, lower gastrointestinal bleeding, iron deficiency anemia, abnormal barium enema, inflammatory bowel disease, abdominal pain, and family history of colon cancer. The location of adenomatous polyps and hyperplastic polyps was recorded and compared. One hundred sixty-three of 845 consecutive patients (19.3{\%}) had at least one colonic polyp. The prevalence of adenomatous polyps alone was 10.3{\%}, hyperplastic polyps 9{\%}, and both types 1.9{\%}. The prevalence rate had an adenomatous polyp in patients without a hyperplastic polyp was 15{\%}. In contrast, among patients with a hyperplastic polyp, 49{\%} had a synchronous adenomatous poly. Only 3.4{\%} of patients had an adenomatous polyp proximal to the splenic flexure when no polyps were present in the left colon. Conversely, among the 29 patients in whom an isolated hyperplastic polyp was found in the left colon, there was a 32.5{\%} prevalence of adenomatous polyps in the proximal colon (p < 0.01). The results of this study suggest that left-sided hyperplastic colonic polyps (generally within the reach of a screening sigmoidoscopy) serve as a marker for neoplastic polyps.",
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AU - O'Kieffe, D. A.

AU - Korman, L. Y.

AU - Benjamin, S. B.

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