Materiały źródłowe

• #1 Colon Polyps: Symptoms, Causes, Types & Removal

  https://my.clevelandclinic.org/health/diseases/15370-colon-polyps

  Colon polyps are common, and many are harmless. But some types can grow into cancer if they aren’t removed. This is why healthcare providers look for polyps in your colon during a colonoscopy, an exam inside your colon. While polyps aren’t cancer, almost all colorectal cancer starts from a polyp. […] The best way to find and identify colon polyps is with a colonoscopy. This is an exam that looks inside your colon with a lighted camera. While other types of imaging tests can find colon polyps, a colonoscopy allows a healthcare provider to find and remove polyps during the same procedure. […] Healthcare providers classify colon polyps as neoplastic or non-neoplastic to indicate whether they can grow into cancer or not. Neoplastic polyps can grow into cancer. Non-neoplastic polyps can’t. […] Most colon polyps have the potential to become cancerous, which is why healthcare providers remove them during a colonoscopy. But very few of them actually do turn into cancer, and it takes a long time for them to do so. Routine colonoscopies remove polyps before they have the chance to become cancer.

• #2 Screening Tests to Detect Colorectal Cancer and Polyps – NCI

  https://www.cancer.gov/types/colorectal/screening-fact-sheet

  Most colorectal cancers begin as an abnormal growth, or lesion, in the tissue that lines the inner surface of the colon or rectum. Lesions may appear as raised polyps, or, less commonly, they may appear flat or slightly indented. Raised polyps may be attached to the inner surface of the colon or rectum with a stalk (pedunculated polyps), or they may grow along the surface without a stalk (sessile polyps). […] Colorectal polyps are common in people older than 50 years of age, and most do not become cancer. However, a certain type of polyp known as an adenoma is more likely to become a cancer. […] Several different screening tests are available that can help doctors find colorectal cancer before symptoms begin, when it may be more treatable. Some of these tests also allow adenomas and polyps to be found and removed before they become cancer. That is, some types of colorectal cancer screening may allow for cancer prevention in addition to early detection.

• #3 All About Colon Polyps | OncoLink

  https://www.oncolink.org/cancers/gastrointestinal/colon-cancer/risk-prevention-and-screening/all-about-colon-polyps

  A colon polyp is a mass of tissue on the inside wall of the colon that protrudes into the colon „tube.” […] Polyps can be found with colon cancer screening tests, such as colonoscopy. […] Many tests are used to find polyps. The test most often used is colonoscopy. […] Most colon cancers start as a polyp but only a very small number of colon polyps become cancer. […] Polyps are treated by removal (polypectomy) during colonoscopy using electrocautery. This means they are cut out and the tissue is burned to seal off the tissue and blood vessels and stop any bleeding. […] Taking out adenomas greatly lowers the risk of developing colon cancer. Based on the National Polyp Study, polypectomy lowers the risk of colon cancer by up to 80%. […] Once a person has their first screening colonoscopy, further follow-up is recommended based on the findings of that first test.

• #4 Colon Polyps: Symptoms, Causes, Types & Removal

  https://my.clevelandclinic.org/health/diseases/15370-colon-polyps

  Removing neoplastic polyps reduces your risk of developing colorectal cancer by 80%. But once you’ve had polyps, you’re likely to have them again. Your healthcare provider will judge your risk of future polyps based on the polyps you’ve had before. They’ll schedule your next screening based on that risk. […] Colon polyps can be serious because of their potential to turn into cancer. But most polyps aren’t cancerous when they’re found. Some might grow into cancer over time if they’re left untreated. Healthcare providers remove them when they find them to prevent this from happening.

• #5 Colon Polyps Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/colon-polyps/diagnosis.html

  Most colon polyps are found during tests for colorectal cancer. Unless the polyps are large and cause bleeding or pain, the only way to know if you have polyps is to have tests that explore the inside of your colon. […] Several tests can be used to detect colon polyps. The tests may be used to screen for colon polyps and colorectal cancer. They can also be used as follow-up tests after colon polyps have been removed. […] An abnormal result from a stool test doesn’t mean that you have colorectal cancer. It might be a false-positive result. So the next step is to have a colonoscopy. After you’ve had it, you and your doctor will know whether or not you have cancer. […] During a sigmoidoscopy exam, samples of any growths can be collected (biopsy). And precancerous and cancerous polyps can sometimes be removed. But if your doctor finds polyps, you will need to have a colonoscopy to check the upper part of your colon.

• #6 Colonic Polyps: Diagnosis and Surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6878826/

  Patients with increased risk should initiate screening earlier and undergo surveillance at shorter intervals than average-risk individuals. […] High-risk individuals include patients with a significant family history of CRC or polyps, those with likely or confirmed hereditary CR cancer syndromes, and those with high-risk medical conditions. […] Colonoscopy is widely considered the gold standard for CR screening, as it allows for both detection and excision of premalignant lesions from the entire colon and rectum. […] Colonoscopy remains a procedure with rare but serious complications, and therefore informed consent is imperative. […] If the initial method for CR screening for an average-risk patient was a colonoscopy, ongoing screening and surveillance depends on findings at initial colonoscopy and any applicable histopathology.

• #7 Colon Polyps – Coastal Gastroenterology Associates

  https://coastalgastrodocs.com/conditions-and-diseases/colon-polyps/

  Colon polyps are growths that develop over time in the inner lining of the colon (large intestine) or rectum. […] Most often, a colon polyps diagnosis is given only after a screening test, such as a flexible sigmoidoscopy, which can remove many types of polyps during the test. […] In order to be treated for colon polyps, you first need a colon polyps diagnosis. […] Other ways to receive a colon polyps diagnosis include: […] You should be screened for polyps and colorectal cancer if you are age 45 or over, or younger if you meet the criteria for certain risk factors. […] Scheduling a consultation with a gastroenterologist is recommended if you suspect you have colon polyps or are experiencing other GI symptoms. This can provide a colon polyps diagnosis or rule out other problems.

• #8 Patient education: Colon polyps (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/colon-polyps-beyond-the-basics/print

  COLON POLYP DIAGNOSIS […] Polyps usually do not cause symptoms but may be detected during a colon cancer screening examination (such as flexible sigmoidoscopy or colonoscopy) or after a positive screening test for occult blood in the stool. […] Colonoscopy is the best way to evaluate the colon for polyps because it allows the clinician to see the entire lining of the colon and remove most polyps that are found (occasionally, large polyps need to be removed during a separate procedure). During colonoscopy, a clinician inserts a very thin, flexible tube with a light source and small camera into the anus. The tube is advanced through the entire length of the large intestine (colon). Virtual colonoscopy using computed tomography technology is another test used to visualize polyps. […] Colonoscopy is the best test for the follow-up examination of polyps. […]

• #9 Colorectal polyps – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/802

  Colorectal polyps (adenomas) are predominantly asymptomatic. […] Colonoscopic polypectomy is diagnostic and therapeutic. Polypectomy reduces the incidence of colorectal cancer by up to 90%. […] This topic covers diagnosis and treatment of sporadic colorectal polyps. […] Key diagnostic factors include family history. […] Other diagnostic factors include rectal bleeding, mucus discharge, weight loss, tenesmus, change in bowel habit, and symptoms and signs of anemia. […] 1st tests to order include colonoscopy, CT colonography, chromoendoscopy, and histology. […] Tests to consider include flexible sigmoidoscopy. […] Emerging tests include virtual chromoendoscopy techniques, artificial intelligence-assisted colonoscopy, and capsule endoscopy.

• #10 Patient education: Colon polyps (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/colon-polyps-beyond-the-basics

  COLON POLYP REMOVAL […] Colorectal cancer is preventable if precancerous polyps (ie, adenomas) are detected and removed before they become malignant (cancerous). Over time, small polyps can change their structure and become cancerous. Polyps are usually removed when they are found on colonoscopy, which reduces the chance for that polyp to become cancerous. […] Procedure — The medical term for removing polyps is polypectomy. Most polypectomies can be performed through a colonoscope. Small polyps can be removed with an instrument that is inserted through the colonoscope. Larger polyps are usually removed by placing a noose, or snare, around the polyp base and burning through it with electric cautery. The cautery also helps to stop bleeding after the polyp is removed. […] Polyp removal is not painful because the lining of the colon does not have the ability to feel pain. In addition, a sedative medication given before the colonoscopy can prevent pain caused by stretching of the colon. Rarely, a polyp will be too large to remove during colonoscopy, which means that a surgical procedure will be needed at a later time.

• #11 Diagnosis of Colon Polyps – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/colon-polyps/diagnosis

  Doctors can find colon polyps only by using certain tests or procedures, such as a colonoscopy or imaging study. […] Your doctor can find colon polyps only by using certain tests or procedures. […] Flexible sigmoidoscopy can show irritated or swollen tissue, ulcers, polyps, and cancer. […] Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer. […] Virtual colonoscopy can show ulcers, polyps, and cancer. […] A lower GI series is also called a barium enema.

• #12 Colon Polyps: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/colorectal-cancer/colon-polyps-basics

  Are all colon polyps seen on a CT scan? […] Screening CT colonography, sometimes called virtual colonoscopy, uses CT technology to take hundreds of images of your colorectal area. Together, these images give your doctor a detailed view inside your colon and rectum. CT colonography can detect cancer and large polyps at about the same rate as traditional colonoscopy, though it may not be as likely to find smaller polyps. […] You don’t need to be sedated before a virtual colonoscopy. Before you get one, you’ll do the same type of bowel-cleaning prep as you would with a colonoscopy. If your doctor finds polyps that need to be removed, you’ll have that done during a traditional colonoscopy.

• #13 Hospital tests and colonoscopies | Bowel Cancer UK | Bowel Cancer UK

  https://www.bowelcanceruk.org.uk/about-bowel-cancer/diagnosis/hospital-tests/

  You may be referred to hospital for further tests such as a colonoscopy, if you’ve visited your GP with symptoms of bowel cancer or if your screening test found blood in your poo. This is to find out what is causing your symptoms. […] Flexible sigmoidoscopy looks inside the rectum (back passage) and the lower part of the large bowel (sigmoid colon). This is where most polyps (non-cancerous growths) and bowel cancers start. […] A colonoscopy looks at the lining of your whole large bowel, to see if there are polyps or a cancer within any part of it. […] A virtual colonoscopy can detect shape changes such as polyps within the bowel. However, it cant easily spot flat areas of inflammation or changes in the lining of the bowel. […] If the pictures show anything that needs to be checked, you may be referred for further tests, such as a colonoscopy.

• #14 Colorectal Polyps: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/colorectal-diseases/colorectal-polyps/treatment

  How Are Colorectal Polyps Diagnosed? […] Colorectal polyps are found through screening tests. These tests play a crucial role in detecting precancerous polyps and preventing colon cancer. […] There are several types of screening tests for colorectal polyps, including: […] Colonoscopy. During a colonoscopy, a trained specialist (gastroenterologist or colorectal surgeon) will insert a long, thin tube with a light and camera on the end into your rectum and colon. The doctor will look for colorectal polyps and, if found, remove them or a tissue sample to be examined at a laboratory. […] CT colonoscopy. Also referred to as a virtual colonoscopy, an X-ray image of your colon is created with a computer. If a polyp is discovered, you will undergo a colonoscopy to have it removed. […] Flexible sigmoidoscopy. Like a colonoscopy, a flexible sigmoidoscopy uses a long, flexible tube with a camera and light at the end to examine your colon.

• #15 Colon Polyps: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/colorectal-cancer/colon-polyps-basics

  Flexible sigmoidoscopy. This test is similar to a colonoscopy, but you dont have to do as much bowel prep. You might take medicine that helps you relax during the procedure. Your doctor puts a thin tube with a light into your bottom to look only at the lower part of your colon. If you have a polyp, they can remove it during the test. It takes about 20 minutes. […] Stool tests. A FOBT (fecal occult blood test) and a FIT (fecal immunochemical test) look for tiny traces of blood in your poop. Stool DNA tests check for gene changes. For any of these tests, you collect a poop sample at home and take it to your doctors office or send it to a lab. If the tests find problems, youll need to have a colonoscopy. […] Lower gastrointestinal series (barium enema). Before this test, the radiologist will fill your large intestine with a chalky liquid called barium. This makes your colon easier to see during an X-ray.

• #16 Screening Tests to Detect Colorectal Cancer and Polyps – NCI

  https://www.cancer.gov/types/colorectal/screening-fact-sheet

  If an abnormality is found during a standard colonoscopy it will be removed (polypectomy) or a biopsy performed, and the cells will be examined to see if cancer is present. If an abnormality is found during a sigmoidoscopy, polypectomy or biopsy may or may not be performed, and a follow-up colonoscopy may be recommended. If a different screening test finds an abnormality, a colonoscopy will be needed to examine the colon directly.

• #17 Colorectal Polyps: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/colorectal-diseases/colorectal-polyps/treatment

  Stool-based testing. A sample of your feces is examined for traces of blood, and a stool DNA test checks for abnormal genetic changes. If irregularities are found, a colonoscopy will be necessary. This noninvasive screening test is generally recommended for people with low to average risk of having colorectal polyps. […] Removing colorectal polyps is the best way to prevent colon cancer. The leading gastroenterologists and colorectal surgeons at NewYork-Presbyterian can recognize the signs and symptoms of colon polyps and provide an expert diagnosis and individualized treatment plan.

• #18 Colorectal Cancer Screening Tests | Sigmoidoscopy & Colonoscopy | American Cancer Society

  https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html

  Several tests can be used to screen for colorectal cancer (see American Cancer Society Guideline for Colorectal Cancer Screening). Colonoscopy, a screening test, can even prevent colorectal cancer by finding polyps before they turn into cancer. […] If you choose to be screened with a test other than colonoscopy, any abnormal test result should be followed up with a timely colonoscopy. […] These tests look at the stool (feces) for possible signs of colorectal cancer or polyps, such as small amounts of blood or changes in the DNA or RNA from cells in the stool. […] If the result from a stool-based test is abnormal, you will still need a colonoscopy to see if you have colorectal cancer. […] The idea behind this is that blood vessels in larger colorectal polyps or in cancers are often fragile and easily damaged when stool passes through.

• #19 Colorectal Cancer Screening Tests | Sigmoidoscopy & Colonoscopy | American Cancer Society

  https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html

  If the test result is positive (that is, if hidden blood is found), a colonoscopy will be needed to investigate further. […] If a pre-cancerous polyp (an adenoma) or colorectal cancer is found, you’ll need to have a colonoscopy later to look for polyps or cancer in the rest of the colon. […] If the test result is positive (if hidden blood is found), a colonoscopy will be needed to find the reason for the bleeding. […] If the test result is positive (if it finds DNA changes, RNA changes, or blood), a colonoscopy will need to be done. […] Colonoscopy will be needed if results are abnormal. […] Colonoscopy will be needed if results are abnormal. […] Colonoscopy will be needed if results are abnormal. […] Colonoscopy will be needed if results are abnormal.

• #20 Colonic Polyps Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/172674-workup

  No laboratory test can determine definitively whether a given patient has a colonic polyp. A stool occult blood test can detect a fraction (20-40%) of colonic polyps that are larger than 10 mm in diameter but, it may also indicate other causes of gastrointestinal blood loss. […] Colonoscopy is the preferred test to detect colonic polyps, obtain biopsies, and/or perform endoscopic resection of polyps. Sensitivities for large colonic polyps in the 80%-90% range have been reported. […] Flexible sigmoidoscopy is a good screening test and is the only procedure or imaging modality to be validated by studies that document a decrease in colorectal cancer mortality. […] An ingestible, camera-equipped capsule developed as a means of exploring the gastrointestinal tract was approved by the FDA in 2014 for the detection of colon polyps in patents who have had an incomplete optical colonoscopy. […] Tests have been developed that detect mutant, fragmented, and/or methylated DNA from exfoliated colon tumor cells in stool. These tests have shown the ability to detect a substantial fraction of tumors in clinical trials but are expensive and appear to be less sensitive than colonoscopy.

• #21 Colorectal polyps – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/802?locale=ar

  Colonoscopy is diagnostic and therapeutic. Polypectomy reduces the incidence of colorectal cancer by up to 90%. […] Surveillance after polypectomy is based upon polyp size, number, and histopathology. […] This topic covers diagnosis and treatment of sporadic colorectal polyps. […] Key diagnostic factors include family history. […] Other diagnostic factors include rectal bleeding, mucus discharge, weight loss, tenesmus, change in bowel habit, and symptoms and signs of anemia. […] 1st tests to order include colonoscopy, CT colonography, chromoendoscopy, and histology. […] Tests to consider include flexible sigmoidoscopy. […] Emerging tests include virtual chromoendoscopy techniques, artificial intelligence-assisted colonoscopy, and capsule endoscopy.

• #22 Polyp Classification: NICE – Endoscopy Campus

  https://www.endoscopy-campus.com/en/classifications/polyp-classification-nice/

  The NICE (NBI International Colorectal Endoscopic) Classification is based on narrow-band images of colon polyps. The classification uses staining, vascular patterns, and surface patterns to distinguish between hyperplastic and adenomatous colon polyps. Clinically, the classification is used for small polyps ( 5 mm or 10 mm). […] This classification can be applied using colonoscopes both with or without optical (zoom) magnification. […] The presence of high grade dysplasia or superficial submucosal carcinoma may be suggested by an irregular vessel or surface pattern, and is often associated with atypical morphology (e.g., depressed area).

• #23 Colon polyps – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875

  Most colon polyps are harmless. […] Colon polyps don’t usually cause symptoms. It’s important to have regular screening tests because colon polyps found early can usually be removed safely and completely. The best prevention for colorectal cancer is regular screening. […] Most people with colon polyps do not have any symptoms. Colon polyps are often found as a part of routine colorectal cancer screening. […] You should be screened regularly for colorectal cancer if: You’re age 45 or older. […] The risk of colon polyps and colorectal cancer may be greatly reduced by having regular screenings.

• #24 Colonic Polyps: Diagnosis and Surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6878826/

  Colorectal (CR) screening for polyp diagnosis and removal can decrease the incidence of, and reduce mortality from, CRC. […] Given the benefits and effectiveness of screening, guidelines exist from multiple organizations. These guidelines risk-stratify patients based on several factors, including age, family history, and other comorbidities and can provide an approach for initiation of screening and continued surveillance. […] The majority of CRCs are diagnosed in patients with no hereditary component and are considered sporadic cancers. Sporadic CRC usually occurs in average-risk individuals. Average-risk individuals are those with no personal history of CRC or premalignant polyps and no history of CRC or premalignant polyps in any first-degree relatives. […] The ACS, MSTF, ACR, and the USPSTF currently recommend initial screening for asymptomatic, average-risk patients starting at the age of 50.

• #25 Colonic Polyps: Diagnosis and Surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6878826/

  Colorectal cancer begins as a polyp that is a benign growth on the mucosal surface of the colon or rectum. Over a period of 5 to 15 years, polyps can degenerate into a cancer, thus invading the colonic wall. Colorectal screening methods are designed to diagnose and remove polyps before they acquire invasive potential and develop into cancer. […] Colonoscopy is held as the gold standard by which all other methods are compared; however, less-invasive modalities including computed tomographic colonography are increasing in popularity. […] Colon and rectal cancer (CRC) is the nation’s third leading cause of cancer mortality and one of the most preventable cancers. CRC begins as a premalignant polyp that grows on the mucosal surface of the colon or rectum and transforms into a malignancy. For adenomas greater than 1 cm in size, cumulative risk of diagnosis of cancer at the polyp site at 5, 10, and 20 years was 2.5, 8, and 24%, respectively.

• #26 Colorectal polyp – Wikipedia

  https://en.wikipedia.org/wiki/Colorectal_polyp

  Colorectal polyps can be detected using a faecal occult blood test, flexible sigmoidoscopy, colonoscopy, virtual colonoscopy, digital rectal examination, barium enema or a pill camera. […] Malignant potential is associated with […] degree of dysplasia […] Type of polyp (e.g. villous adenoma): […] Tubular adenoma: 5% risk of cancer […] Tubulovillous adenoma: 20% risk of cancer […] Villous adenoma: 40% risk of cancer […] Size of polyp: […] 1 cm =1% risk of cancer […] 12 cm=10% risk of cancer […] 2 cm=50% risk of cancer. […] Normally an adenoma that is greater than 0.5 cm is treated.

• #27 Optical Diagnosis for Colorectal Polyps: A Useful Technique Now or in the Future?

  https://www.gutnliver.org/journal/view.html?pn=search&uid=1344&vmd=Full

  In the last few years, interest in the optical diagnosis of colorectal polyps has increased among gastroenterologists. Several studies have shown that the optical diagnosis of small colorectal polyps is safe and feasible in routine clinical practice and is comparable to histopathology. […] A number of studies, including several meta-analyses, have shown that optical diagnosis of small colorectal polyps is safe and feasible in routine clinical practice and comparable to the current reference standard, histopathology. Experienced endoscopists have achieved 93% concordance of surveillance intervals made by real-time optical diagnosis and pathology, and a 90% negative predictive value for rectosigmoid polyps. […] Several studies from both Eastern and Western countries, and either with or without magnification, have demonstrated a high diagnostic accuracy for distinguishing neoplastic from nonneoplastic lesions. A systematic review and meta-analysis including 28 studies that used NBI for optical diagnosis of colon polyp histology in real-time found a high diagnostic accuracy (sensitivity, 91%; specificity, 83%; hierarchical summary receiver operating characteristic curve, 0.92).

• #28

  https://link.springer.com/article/10.1007/s11938-019-00220-x

  Optical diagnosis of diminutive colorectal polyps has been recently proposed as an alternative to histopathologic diagnosis. […] Recent developments in imaging techniques, new classification systems, and the use of artificial intelligence have allowed for increased viability of optical diagnosis. […] There are currently seven major classification systems and three major society recommendations for quality benchmarks for optical diagnosis of diminutive polyps. […] The NICE classification has been extensively studied and meets quality benchmarks for most imaging techniques but does not allow for the diagnosis of sessile serrated polyps (SSPs). […] The SIMPLE classification has met quality benchmarks for NBI and i-Scan and allows for the diagnosis of SSPs. […] Computer-assisted diagnosis of colorectal polyps is a very promising recent development with first studies showing that society-recommended quality benchmarks for real-time colonoscopies on patients are being met.

• #29 Optical Diagnosis for Colorectal Polyps: A Useful Technique Now or in the Future?

  https://www.gutnliver.org/journal/view.html?pn=search&uid=1344&vmd=Full

  The endoscopists level of confidence is a crucial factor in optical diagnosis. Only lesions in which the endoscopist has a high level of confidence should be considered for optical diagnosis. […] The NICE classification is the only validated criterion for NBI with and without magnification that describes real-time differentiation of nonneoplastic (type 1) and neoplastic (type 2) colorectal polyps, as well as lesions with deep submucosal invasion (type 3). […] Several studies in the literature have convincingly shown that white light alone is not sufficient for optical diagnosis, since the diagnostic accuracy achieved is significantly lower than with histopathology. […] The implementation of optical diagnosis requires participants to recognize that learning is experiential: a cyclic process of doing, noticing, questioning, reflecting, exploring concepts and models (evidence), and then doing againonly doing it better the next time. […] Optical diagnosis of colorectal polyps can improve the cost-effectiveness of screening colonoscopy. It avoids the cost of a pathology examination, improves efficiency related to the follow-up care, and reduces patients anxiety, as they no longer have to wait for the pathology results.

• #30 Endoscopic diagnosis and treatment planning for colorectal polyps using a deep-learning model | Scientific Reports

  https://www.nature.com/articles/s41598-019-56697-0

  We aimed to develop a computer-aided diagnostic system (CAD) for predicting colorectal polyp histology using deep-learning technology and to validate its performance. […] The overall diagnostic accuracy of the CAD was 81.3-82.4%, which was significantly higher than that of the trainees (63.8-71.8%, P<0.01) and comparable with that of experts (82.4-87.3%). [...] CAD using a deep-learning model can accurately assess polyp histology and may facilitate the diagnosis of colorectal polyps by endoscopists. [...] The CAD diagnostic performance was better overall than that of the trainees and comparable to that of expert endoscopists. [...] The CAD showed a better performance compared to trainees and a slightly inferior or comparable performance to that of experts. [...] These findings suggest that the AI CAD system helps inexperienced endoscopists to correctly predict the histopathology of colorectal polyps and gives expert endoscopists increased confidence in their histological assessments.

• #31 Computer-aided diagnosis of colorectal polyps using linked color imaging colonoscopy to predict histology | Scientific Reports

  https://www.nature.com/articles/s41598-019-39416-7

  We developed a computer-aided diagnosis (CAD) system based on linked color imaging (LCI) images to predict the histological results of polyps by analyzing the colors of the lesions. […] The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of this novel CAD system for the training set were 87.0%, 87.1%, 87.0%, 93.1%, and 76.9%, respectively. […] The CAD system identified adenomatous or non-adenomatous polyps in the test set with an accuracy of 78.4%, a sensitivity of 83.3%, a specificity of 70.1%, a PPV of 82.6%, and an NPV of 71.2%. […] A novel CAD system based on LCI could be a rapid and powerful decision-making tool for endoscopists. […] Therefore, the accurate differentiation between adenomatous polyps and non-adenomatous lesions in vivo during colonoscopy is of significant clinical meaning.

• #32 Computer-aided diagnosis of colorectal polyps using linked color imaging colonoscopy to predict histology | Scientific Reports

  https://www.nature.com/articles/s41598-019-39416-7

  This study demonstrated that the LCI-CAD system has a promising diagnostic potential to predict the histopathology of colorectal polyps based on color analysis, with comparable accuracy to the eyes of human experts. […] The CAD system achieved an accuracy of 87.0% during the training process and 78.4% for the test set of polyps. […] The area under the curve was quite large with sensitivity and specificity, which may be associated with the fact that a novel CAD system based on LCI could be a rapid and powerful decision-making tool for endoscopists.

• #33 Endoscopic diagnosis and treatment planning for colorectal polyps using a deep-learning model | Scientific Reports

  https://www.nature.com/articles/s41598-019-56697-0

  Therefore, we believe that CAD assistance will help endoscopists more reliably determine the appropriate treatment plan for colorectal polyps. […] The diagnostic performance of the CAD was comparable to that of expert endoscopists and better than that of trainees. Real-time histological assessment of colorectal polyps by the CAD may enhance endoscopists decision-making and confidence in the selection of appropriate treatment plans.

• #34 Colon Polyps Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/colon-polyps/diagnosis.html

  During the test, samples of any growths can be collected (biopsy). And precancerous and cancerous polyps usually can be removed. […] If a biopsy of polyps found during screening shows only hyperplastic polyps of any size, routine follow-up screening is all that is needed. These polyps don’t become cancerous. […] Most doctors agree that if you’ve had one or more adenomatous polyps removed, you probably need regular follow-up colonoscopy exams every few years. This type of polyp is more likely to turn into cancer. But that risk is still very low. […] How often you need a colonoscopy may depend on the number and size of the polyps, your age, your health, and other risk factors that you may have for polyps. Talk with your doctor about the follow-up testing schedule that is right for you.

• #35 Updated surveillance guidance for people who have had polyps or previous cancer removed | Bowel Cancer UK

  https://www.bowelcanceruk.org.uk/news-and-blogs/research-blog/updated-surveillance-guidance-for-people-who-have-had-polyps-or-previous-cancer-removed/

  Surveillance is a term used to describe 'check-up’ colonoscopies that a person might receive after they have had bowel polyps (non-cancerous growths) or a bowel cancer removed. A colonoscopy is an examination using a thin flexible tube with a camera on the end to look inside the bowel. […] The purpose of surveillance colonoscopies is to find and remove new polyps, to reduce the risk of bowel cancer developing in the future. Colonoscopies can also help detect bowel cancer at an early stage, when treatment has the best chance of working. […] Most people who have one polyp removed after their initial colonoscopy won’t usually need surveillance. Surveillance is for people at higher risk of developing more polyps that might later develop into bowel cancer. The aim is to make surveillance more personalised, ensuring it is recommended for people who are at risk of new polyps and should have future surveillance colonoscopies.

• #36 Updated surveillance guidance for people who have had polyps or previous cancer removed | Bowel Cancer UK

  https://www.bowelcanceruk.org.uk/news-and-blogs/research-blog/updated-surveillance-guidance-for-people-who-have-had-polyps-or-previous-cancer-removed/

  The updated guideline states that people who have had the following removed at colonoscopy are defined as having 'high risk findings’ and should go on to have surveillance: Two or more polyps (including at least one advanced polyp) or; Five or more polyps. […] For people who have had a bowel cancer removed, it is recommended that, after treatment, patients should have a follow-up colonoscopy after one year and another surveillance colonoscopy after a further three years. […] High risk of developing more polyps: Most people with 'high risk findings’ during a colonoscopy will be invited to have surveillance after three years. […] It usually takes at least 10 years for a polyp to develop into a high-risk polyp or cancer. Although colonoscopy is generally a safe procedure, the risks of a complication are greater in people over 75, so in general surveillance colonoscopy is not recommended for those over this age.

• #37 Polyps in Colon: Symptoms, Diagnosis, Causes & Treatment – Tua Saúde

  https://www.tuasaude.com/en/polyps-in-colon/

  Treatment for polyps in the colon involves removing them during a colonoscopy, which is referred to as a polypectomy. […] After removal, these polyps are sent to the laboratory for analysis to check for signs of malignancy. […] The doctor may recommend repeating the exam after a few years to check for new polyps and remove them as necessary.

• #38 Patient education: Colon polyps (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/colon-polyps-beyond-the-basics/print

  The results of the tissue analysis of polyps are discussed with patients when they are available, within a few weeks after the procedure, to decide if and when a follow-up examination is needed. People with adenomatous polyps have an increased risk of developing more polyps. There is a 25 to 30 percent chance that adenomas will be present on a repeat colonoscopy done three years after the initial polypectomy. Some of these polyps may have been present during the original examination but were too small to detect. Other new polyps may also have developed.

• #39 Colon polyps: 10 things to know | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/colon-polyps–10-things-to-know.h00-159538167.html

  If youre age 45 or older, your doctor may have already talked to you about the need to start getting a colonoscopy to check for polyps. […] Colonoscopy is the preferred method of screening for colorectal cancer. […] Looking for them during a colonoscopy is a standard part of colorectal cancer screening. […] Most colon polyps can be removed during a colonoscopy. […] Which procedure is called for depends entirely on each patient and their unique situation. […] If you have a lot of polyps, or theyre very large or pre-cancerous, you might need to be scoped more often. […] Polyps themselves are not cancer. Some just have the potential to develop into it. We remove them so they never have that chance.

• #40 Gastrointestinal Polyposis Syndromes > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/gastrointestinal-polyposis-syndromes

  A gastrointestinal (GI) polyp is an abnormal growth of tissue that projects from the inner lining of the colon, rectum, stomach, or other parts of the digestive (or GI) tract. […] Because of the increased risk of cancer and young age of onset, those with a polyposis syndrome typically get colonoscopies at a younger age and more frequently than usual. […] Diagnosis of polyposis syndromes may involve a review of the patients medical history, a physical exam, and one or more procedures or tests. […] If a doctor suspects a patient may have a polyposis syndrome, they may begin to make a diagnosis by asking whether the patient has a family history of colorectal cancer or a polyposis syndrome, what symptomsif anyare present, and when they began. […] During the physical exam, the doctor will look for signs that could indicate a polyposis syndrome.

• #41 Gastrointestinal Polyposis Syndromes > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/gastrointestinal-polyposis-syndromes

  Certain tests and procedures are also used to identify and diagnose polyposis syndromes, including: Colonoscopy and/or sigmoidoscopy. […] If polyps are detected during the exam, they can be removed and then analyzed in a lab to determine whether the tissue is abnormal or cancerous. […] People with a polyposis syndrome should get colonoscopies or sigmoidoscopies at a younger age and at shorter intervals (often every one to three years) than usual to detect and remove colorectal polyps. […] The surgical removal of the entire colon (total colectomy), part of the colon (subtotal colectomy), or the colon and the rectum (proctocolectomy) may be done as a preventive measure to prevent colorectal cancer from developing or, if cancer has developed, to eradicate it from the body. […] Nonsteroidal anti-inflammatory drugs (NSAIDs), such as sulindac, may reduce the number and size of colorectal polyps in people with FAP. […] It is unknown, however, whether sulindac protects against colorectal cancer.

• #42 Colon and Rectal Cancer Detection & Diagnosis | WVCI

  https://www.oregoncancer.com/colorectal-cancer/diagnosis

  Fortunately, several screening tests for colon and rectal cancers exist, including some recently made widely available. […] Regular screening can also prevent it by allowing your doctor to find and remove polyps before they have a chance to turn into cancer. […] If tests show an abnormal area (such as a polyp), a biopsy to check for cancer cells may be necessary. […] Any polyps biopsied during a colonoscopy will be sent for testing. If they return a cancer diagnosis, your cancer doctor will work to stage the cancer. […] It is important to remember that not all polyps are cancerous.

• #43 Patient education: Colon polyps (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/colon-polyps-beyond-the-basics

  Complications — Polypectomy is safe although it has a few potential risks and complications. The most common complications are bleeding and perforation (creating a hole in the colon). Fortunately, this occurs infrequently (one in 1000 patients having colonoscopy). Bleeding can usually be controlled during colonoscopy by cauterizing (applying heat) to the bleeding site; surgery is sometimes required for perforation. […] Medication use — Nonsteroidal anti-inflammatory drugs including aspirin, ibuprofen, and naproxen can usually be continued before your colonoscopy. Acetaminophen is safe to take. People who require anticlotting medications such as warfarin should discuss how and when to stop and resume this medication with their clinician.

• #44 All About Colon Polyps | OncoLink

  https://www.oncolink.org/cancers/gastrointestinal/colon-cancer/risk-prevention-and-screening/all-about-colon-polyps

  A colon polyp is a mass of tissue on the inside wall of the colon that protrudes into the colon „tube.” […] Polyps can be found with colon cancer screening tests, such as colonoscopy. […] Many tests are used to find polyps. The test most often used is colonoscopy. […] Most colon cancers start as a polyp but only a very small number of colon polyps become cancer. […] Polyps are treated by removal (polypectomy) during colonoscopy using electrocautery. This means they are cut out and the tissue is burned to seal off the tissue and blood vessels and stop any bleeding. […] Taking out adenomas greatly lowers the risk of developing colon cancer. Based on the National Polyp Study, polypectomy lowers the risk of colon cancer by up to 80%. […] Once a person has their first screening colonoscopy, further follow-up is recommended based on the findings of that first test.

• #45 Malignant Colorectal Polyps: Diagnosis, Treatment and Prognosis | IntechOpen

  https://www.intechopen.com/chapters/42026

  The risk of relapse ranges from 0% to 2% in malignant polyps with a margin of resection greater than 1 mm. […] If the resection margin is involved, or is less than 1 mm, the percentage of relapse ranges between 21% and 33%. […] In cases of non-invasive high grade neoplasia and malignant polyps with pedunculated morphology and favourable histological criteria, it is recommended that a colonoscopy be carried out three months after taking the biopsy. […] If this is normal, a further check-up is advised after one year, three years and five year. […] The prognosis correlates with the histological grade.

• #46 Malignant Colorectal Polyps: Diagnosis, Treatment and Prognosis | IntechOpen

  https://www.intechopen.com/chapters/42026

  During screening programmes, adenocarcinomas have been detected in between 3% – 4.6% of those who undergo colonoscopy following a positive immunological faecal occult blood test result. […] The type of polyp and its morphology can guide the endoscopist towards its potential malignancy. […] In such suspicious lesions, as well as in flat or depressed lesions, diagnosis can be carried out using chromoendoscopy and magnification techniques that can highlight abnormalities of glandular cytoarchitecture and reveal information concerning the extent of submucosal invasion. […] The success of treatment of a malignant polyp depends on the complete resection by polypectomy or surgical intervention. […] When en-bloc removal of a polyp is performed, it is possible to assess the depth of infiltration of the tumour cells and whether the margin is affected.

• #47 Optical diagnosis of colorectal polyps using high-definition i-scan: An educational experience

  https://www.wjgnet.com/1007-9327/full/v19/i27/4334.htm

  Accurate optical diagnosis may allow the endoscopist to leave diminutive non-adenomatous polyps of the rectosigmoid in place and remove and discard diminutive adenomas, thereby reducing the pathology costs and potential risks of complications. […] The current study shows that endoscopists can predict polyp histology with a mean accuracy of 84.0% (high confidence diagnosis) using HD i-scan still images. […] The results of our study are consistent with the findings reported in a study by Pig et al in which an experienced endoscopist predicted the histology of 150 colorectal polyps during colonoscopy with a sensitivity, specificity and accuracy of 95%, 82% and 92%, respectively. […] This study highlights the importance of training in attaining practical skills in optical diagnosis using new image enhanced endoscopy techniques.

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