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General medicine
Individuals with high-risk adenomas are at elevated risk for colorectal cancer
  1. Joseph C Anderson1,2
  1. 1 Department of Veterans Affairs Medical Center, VA Medical Center, White River Junction, Vermont, USA
  2. 2 The Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
  1. Correspondence to Dr Joseph C Anderson, Department of Veterans Affairs Medical Center, VA Medical Center, White River Junction VT 05009, USA; joseph.anderson{at}

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Commentary on: Click B, Pinsky PF, Hickey T, et al. Association of colonoscopy adenoma findings with long-term colorectal cancer incidence. JAMA 2018;319:2021–2031.


Currently, in part due to lack of data, endoscopists recommend intervals that are shorter than those suggested by guidelines.1 2 Thus, data regarding long-term colorectal cancer (CRC) risk for index adenomas are crucial for endoscopists in managing adenoma surveillance. Specifically, how does the long-term CRC risk for advanced adenomas compare with that for non-advanced adenomas or normal exams?


The current paper3 analyses the long-term data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial prospective cohort study. The trial, which started in 1993, enrolled adults aged 55–74 years who were randomised to having a flexible sigmoidoscopy at baseline and at year 3 or year 5 versus having usual care. Those with a polyp on flexible sigmoidoscopy were offered a full colonoscopy.

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.