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  • Long-term follow-up after removal of colorectal adenomas provides evidence for risk stratification of patients at colonoscopic polypectomy

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Prognosis
Cohort study
Long-term follow-up after removal of colorectal adenomas provides evidence for risk stratification of patients at colonoscopic polypectomy
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  1. Sidney J Winawer
  1. Memorial Sloan Kettering Cancer Center, New York, New York, USA
  1. Correspondence to : Dr Sidney J Winawer, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; winawers{at}mskcc.org

https://doi.org/10.1136/ebmed-2014-110110

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    Commentary on: Loberg M, Kalager M, Holme O, et al. Long-term colorectal-cancer mortality after adenoma removal. N Engl J Med 2014;371:799–807.OpenUrlCrossRefPubMedWeb of Science

    Context

    The association of colorectal cancer (CRC) with pre-existing adenomatous polyps was challenged for decades until the National Polyp Study (NPS) demonstrated that colonoscopic polypectomy prevented deaths from CRC.1 In a follow-up of the Minnesota Colon Cancer Control study (46 551 participants), those randomly assigned to annual screening with a sensitive faecal occult blood test, sustained a 32% CRC mortality reduction over 30 years which was consistent with the effect of polypectomy.2 In the Nurses’ Health Study and the Health Professional Follow-up Study (88 902 participants followed over 22 years), lower endoscopy was associated with a 43% CRC mortality reduction compared to no endoscopy.3 …

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