Colorectal polyps can sometimes indicate an increased likelihood a person may develop colorectal cancer (CRC). However, it is unknown which types of polyps are more strongly associated with CRC development, and if certain polyps indicate a higher risk. To clarify the link between different types of polyps and risk of CRC, a recent study analyzed long-term outcomes for 178,377 patients with colorectal polyps included in the Swedish gastrointestinal pathology cohort from 1993 to 2016. The authors compared types of polyps to incidence of CRC and CRC-related death.
After a median 6.6 years of follow-up, 4278 patients with colorectal polyps developed CRC and 1269 patients died due to CRC. In a reference group of 864,831 individuals without polyps, 14,350 developed CRC and 5242 died from CRC. Among patients with colorectal polyps, risk of CRC and CRC-related death varied by polyp type. The highest risk of CRC was seen in patients with villous adenomas, with an 8.6% 10-year cumulative incidence of CRC. However, almost types of polyps were associated with an increased risk of CRC compared to reference patients. The 10-year cumulative incidence rate was 2.1% in patients without polyps, compared to 5.1% in patients with tubulovillous adenomas, 2.7% for tubular adenomas, and 2.5% for sessile serrated polyps. Patients with sessile serrated polyps, tululovillous adenomas, and villous adenomas were more likely to die of CRC than patients without polyps. There was no increase in CRC-related deaths among patients with hyperplastic polyps or tubular adenomas.
The investigators concluded that colorectal polyps are associated with an increased risk of CRC regardless of subtype, but that certain polyp types, included sessile serrated polyps, tubulovillous adenomas, and villous adenomas, are linked to greater risk of developing CRC and higher rates of CRC-related mortality.
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