Featured Research

from universities, journals, and other organizations

Flat Colon Lesions Relatively Common, Associated With Colorectal Cancer

Date:
March 7, 2008
Source:
JAMA and Archives Journals
Summary:
Flat, non-polypoid colorectal neoplasms, which may be difficult to detect, appear to be relatively common and may have a greater association with cancer compared with the more routinely diagnosed type of colorectal polyps, according to a new study.

Flat, non-polypoid colorectal neoplasms (NP-CRNs), which may be difficult to detect, appear to be relatively common and may have a greater association with cancer compared with the more routinely diagnosed type of colorectal polyps, according to a study in the March 5 issue of JAMA.

Colorectal cancer is the second leading cause of cancer death in the United States. Prevention has focused on the detection and removal of polypoid (resembling a polyp) neoplasms (a new and abnormal growth). Recent studies, however, have demonstrated that colorectal cancer can also arise from NP-CRNs. "Nonpolypoid colorectal neoplasms are more difficult to detect by colonoscopy or computed tomography colonography because the subtle findings can be difficult to distinguish from those of normal mucosa [membrane]. As compared with surrounding normal mucosa, NP-CRNs appear to be slightly elevated, completely flat, or slightly depressed," the authors write. Data are limited on the significance of NP-CRNs.

Roy M. Soetikno, M.D., M.S., and colleagues with the Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif., examined data from a group of 1,819 patients undergoing elective colonoscopy to estimate the prevalence of NP-CRNs and to characterize the association of NP-CRNs with colorectal cancer.

The overall prevalence of NP-CRNs was 9.35 percent (n = 170). The prevalence of NP-CRNs in the subpopulations for screening, surveillance, and symptoms was 5.84 percent, 15.44 percent, and 6.01 percent, respectively. The overall prevalence of NP-CRNs with cancer that had not spread or had spread in tissue beneath the mucous membrane was 0.82 percent; in the screening population, the prevalence was 0.32 percent. Overall, NP-CRNs were nearly 10 times more likely to contain cancerous tissue than polypoid lesions, irrespective of the size.

The positive size-adjusted association of NP-CRNs with cancer that had not spread or had spread in tissue beneath the mucous membrane was also observed in subpopulations for screening and surveillance. The depressed type of NP-CRNs had the highest risk (33 percent). Nonpolypoid colorectal neoplasms containing cancer were smaller in diameter as compared with the polypoid ones.

"In conclusion, in this population of patients at a single Veterans Affairs hospital, NP-CRNs were a relatively common finding during colonoscopy. They were more likely to contain carcinoma compared with polypoid neoplasms, independent of lesion size. Recent studies have pointed out differences in the genetic mechanisms underlying nonpolypoid and polypoid colorectal neoplasms. Future studies on NP-CRNs should further evaluate whether the diagnosis and removal of NP-CRNs has any effect on the prevention and mortality of colorectal cancer and particularly focus on their genetic and protein abnormalities," the authors write.

Journal reference: JAMA. 2008;299[9]:1027-1035.

Editorial: Nonpolypoid Colorectal Neoplasia

In an accompanying editorial, David Lieberman, M.D., of Oregon Health & Science University, Portland VA Medical Center, Portland, Ore., comments on the findings of Soetikno and colleagues.

"[Nonpolypoid colorectal neoplasms] may be biologically distinct from polypoid lesions and appear to be more likely to harbor malignant features. Detection and complete removal at colonoscopy may be challenging. The current study emphasizes the importance of quality in the performance of colonoscopy," he writes. "The optimal methods for enhancing colonoscopic imaging of NP-CRNs are uncertain. ... Additional studies are needed to determine whether imaging modalities such as computed tomography colonography will be able to detect NP-CRNs. Finally, longitudinal studies are needed to determine whether patients with NP-CRNs require more intensive colonoscopic surveillance compared with patients with polypoid lesions of similar size and histology."

Reference for editorial: JAMA. 2008;299[9]:1068-1069. Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Cite This Page:

JAMA and Archives Journals. "Flat Colon Lesions Relatively Common, Associated With Colorectal Cancer." ScienceDaily. ScienceDaily, 7 March 2008. <www.sciencedaily.com/releases/2008/03/080304173351.htm>.
JAMA and Archives Journals. (2008, March 7). Flat Colon Lesions Relatively Common, Associated With Colorectal Cancer. ScienceDaily. Retrieved September 2, 2014 from www.sciencedaily.com/releases/2008/03/080304173351.htm
JAMA and Archives Journals. "Flat Colon Lesions Relatively Common, Associated With Colorectal Cancer." ScienceDaily. www.sciencedaily.com/releases/2008/03/080304173351.htm (accessed September 2, 2014).

Share This




More Health & Medicine News

Tuesday, September 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Get on Your Bike! London Cycling Popularity Soars Despite Danger

Get on Your Bike! London Cycling Popularity Soars Despite Danger

AFP (Sep. 1, 2014) Wedged between buses, lorries and cars, cycling in London isn't for the faint hearted. Nevertheless the number of people choosing to bike in the British capital has doubled over the past 15 years. Duration: 02:27 Video provided by AFP
Powered by NewsLook.com
Can You Train Your Brain To Eat Healthy?

Can You Train Your Brain To Eat Healthy?

Newsy (Sep. 1, 2014) New research says if you condition yourself to eat healthy foods, eventually you'll crave them instead of junk food. Video provided by Newsy
Powered by NewsLook.com
We've Got Mites Living In Our Faces And So Do You

We've Got Mites Living In Our Faces And So Do You

Newsy (Aug. 30, 2014) A new study suggests 100 percent of adult humans (those over 18 years of age) have Demodex mites living in their faces. Video provided by Newsy
Powered by NewsLook.com
Liberia Continues Fight Against Ebola

Liberia Continues Fight Against Ebola

AFP (Aug. 30, 2014) Authorities in Liberia try to stem the spread of the Ebola epidemic by raising awareness and setting up sanitation units for people to wash their hands. Duration: 00:41 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins