GASTROENTEROLOGY ARTICLE OF THE WEEK
March 29, 2007
Levine JS, Ahnen DJ. Adenomatous polyps of the colon. N Engl J Med 2006;355:2551-7
1. Characteristics that classify a polyp as an advanced adenoma include
a. location in the right colon
b. size > 1 cm
c. the presence of dilated glands
d. villous component
e. high-grade dysplasia in the polyp
f. the presence of a stalk
2. Supplements and medications that may decrease risk of colon cancer include
a. vitamin C
b. COX-2 inhibitors
c. aspirin
d. artichoke extract
e. calcium
f. Non-selective NSAID’s
3. A patient has a 1cm pedunculated polyp resected from the ascending colon. Pathology reports an adenoma with high grade dysplasia. This patient should have a follow up colonoscopy in
a. 3 months
b. 6 months
c. 1 year
d. 3 years
e. 5 years
f. 10 years
g. never
True or False
4. Approximately 35% of adenomas will progress to cancer if not resected
5. The presence of >3 non-advanced adenomas or one or more advanced adenomas on the index colonoscopy increases the risk of metachronous polyp by 2-3 fold
6. A patient with a serrated hyperplastic polyp found in the hepatic flexure can safely have a follow up colonoscopy in 10 years.
7. The miss rate of colonoscopy is estimated to be about 12% for adenomas >1cm and up to 25% for smaller adenomas
8. Patients with only 1 or 2 small adenomas on index colonoscopy should undergo repeat colonoscopy in 3 years
9. You can assure patients that if they adhere to a colonoscopy surveillance program, they will not get colon cancer