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Long-term colorectal-cancer mortality after adenoma removal

Date:
August 28, 2014
Source:
Oslo University Hospital
Summary:
Patients with intestinal polyps have a lower risk of dying from cancer than previously thought, according to researchers. Their study is the world’s largest of its kind.

Patients with intestinal polyps have a lower risk of dying from cancer than previously thought, according to Norwegian researchers. The Norwegian study is the world's largest of its kind.

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BACKGROUND

Although colonoscopic surveillance of patients after removal of adenomas is widely promoted, little is known about colorectal-cancer mortality among these patients.

METHODS

Using the linkage of the Cancer Registry and the Cause of Death Registry of Norway, we estimated colorectal-cancer mortality among patients who had undergone removal of colorectal adenomas during the period from 1993 through 2007. Patients were followed through 2011. We calculated standardized incidence-based mortality ratios (SMRs) using rates for the Norwegian population at large for comparison. Norwegian guidelines recommended colonoscopy after 10 years for patients with high-risk adenomas (adenomas with high-grade dysplasia, a villous component, or a size ≥10 mm) and after 5 years for patients with three or more adenomas; no surveillance was recommended for patients with low-risk adenomas. Polyp size and exact number were not available in the registry. We defined high-risk adenomas as multiple adenomas and adenomas with a villous component or high-grade dysplasia.

RESULTS

We identified 40,826 patients who had had colorectal adenomas removed. During a median follow-up of 7.7 years (maximum, 19.0), 1273 patients were given a diagnosis of colorectal cancer. A total of 398 deaths from colorectal cancer were expected and 383 were observed, for an SMR of 0.96 (95% confidence interval [CI], 0.87 to 1.06) among patients who had had adenomas removed. Colorectal-cancer mortality was increased among patients with high-risk adenomas (expected deaths, 209; observed deaths, 242; SMR, 1.16; 95% CI, 1.02 to 1.31), but it was reduced among patients with low-risk adenomas (expected deaths, 189; observed deaths, 141; SMR, 0.75; 95% CI, 0.63 to 0.88).

CONCLUSIONS

After a median of 7.7 years of follow-up, colorectal-cancer mortality was lower among patients who had had low-risk adenomas removed and moderately higher among those who had had high-risk adenomas removed, as compared with the general population. (Funded by the Norwegian Cancer Society and others.)


Story Source:

The above story is based on materials provided by Oslo University Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. Magnus Løberg, Mette Kalager, Øyvind Holme, Geir Hoff, Hans-Olov Adami, Michael Bretthauer. Long-Term Colorectal-Cancer Mortality after Adenoma Removal. New England Journal of Medicine, 2014; 371 (9): 799 DOI: 10.1056/NEJMoa1315870

Cite This Page:

Oslo University Hospital. "Long-term colorectal-cancer mortality after adenoma removal." ScienceDaily. ScienceDaily, 28 August 2014. <www.sciencedaily.com/releases/2014/08/140828090156.htm>.
Oslo University Hospital. (2014, August 28). Long-term colorectal-cancer mortality after adenoma removal. ScienceDaily. Retrieved November 29, 2014 from www.sciencedaily.com/releases/2014/08/140828090156.htm
Oslo University Hospital. "Long-term colorectal-cancer mortality after adenoma removal." ScienceDaily. www.sciencedaily.com/releases/2014/08/140828090156.htm (accessed November 29, 2014).

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