Materiały źródłowe

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

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

  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. […] 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. […] 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.

• #2 They found colon polyps: Now what? – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/they-found-colon-polyps-now-what

  Follow-up exams at the right time are essential to prevent cancer from developing. […] Colorectal cancer is one of the most preventable forms of cancer if you are screened for hidden warning signs while you are still healthy. […] They are not cancer, and most of them have not started to change into cancer. […] If you get them at the precancerous phase, they don’t have a chance to grow and turn into cancer. […] Overall, only 5% of adenomas progress to cancer, but your individual risk is hard to predict. […] There is a 25% to 30% chance that a repeat colonoscopy will find additional polyps. […] How soon you need to return for follow-up depends largely on the size of the polyps found in the first exam. […] If the colonoscopy finds one or two small polyps (5 mm in diameter or smaller), you are considered at relatively low risk.

• #3 Colon Polyp Size Chart: What’s Cancerous, What’s Not

  https://www.verywellhealth.com/colon-polyp-size-chart-8659874

  Polyps in the colon and rectum (together called colorectal polyps) are common in people over age 50. They are usually noncancerous, but certain characteristics can increase the likelihood of a polyp becoming cancerous. […] The risk of a polyp becoming cancerous increases with size. Polyps that are 10 millimeters (mm) or larger are considered to have a higher cancer risk than ones that are smaller than 10 mm. […] In general terms, colorectal polyps that are 10 mm (1 cm) or bigger in diameter are considered to have a higher risk of becoming cancerous than those smaller than 10 mm. Adenomas and sessile serrated polyps that are 10 mm or more are classified as advanced. […] The risk that a polyp will become cancerous can continue to rise with the size of the polyp. Depending on the type and other factors, up to 50% of polyps over 20 mm (2 cm) are cancerous.

• #4 Colon Polyp Size Chart: What’s Cancerous, What’s Not

  https://www.verywellhealth.com/colon-polyp-size-chart-8659874

  Some research has found that the incidence of polyp cancer is up to 75% when a polyp reaches 35 mm (3.5 cm). […] Research findings have also suggested that advanced adenomas progress to cancer at a higher rate than the average rate for all adenomas, and this advanced rate increases with the age of the person. Advanced adenomas are defined as having at least one of these criteria: At least 10 mm in size, Villous architecture of at least 25%, High-grade dysplasia. […] Though polyps 10 cm or larger in size carry a higher risk of cancer, most adenomas (60% to 75%) detected with colonoscopy are smaller than 10 cm. […] The risk of cancer development can increase with multiple polyps, as well as the risk of developing more polyps in the future, with more than 10 adenomas considered the highest risk.

• #5 Colon Polyp Size Chart: What’s Cancerous, What’s Not

  https://www.verywellhealth.com/colon-polyp-size-chart-8659874

  Some research has found that the incidence of polyp cancer is up to 75% when a polyp reaches 35 mm (3.5 cm). […] Research findings have also suggested that advanced adenomas progress to cancer at a higher rate than the average rate for all adenomas, and this advanced rate increases with the age of the person. Advanced adenomas are defined as having at least one of these criteria: At least 10 mm in size, Villous architecture of at least 25%, High-grade dysplasia. […] Though polyps 10 cm or larger in size carry a higher risk of cancer, most adenomas (60% to 75%) detected with colonoscopy are smaller than 10 cm. […] The risk of cancer development can increase with multiple polyps, as well as the risk of developing more polyps in the future, with more than 10 adenomas considered the highest risk.

• #6 Colon Polyp Size Chart: What’s Cancerous, What’s Not

  https://www.verywellhealth.com/colon-polyp-size-chart-8659874

  Some research has found that the incidence of polyp cancer is up to 75% when a polyp reaches 35 mm (3.5 cm). […] Research findings have also suggested that advanced adenomas progress to cancer at a higher rate than the average rate for all adenomas, and this advanced rate increases with the age of the person. Advanced adenomas are defined as having at least one of these criteria: At least 10 mm in size, Villous architecture of at least 25%, High-grade dysplasia. […] Though polyps 10 cm or larger in size carry a higher risk of cancer, most adenomas (60% to 75%) detected with colonoscopy are smaller than 10 cm. […] The risk of cancer development can increase with multiple polyps, as well as the risk of developing more polyps in the future, with more than 10 adenomas considered the highest risk.

• #7 Colorectal malignant polyps: a modern approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8713339/

  Colorectal malignant polyps (MP) are polyps with invasive cancer into the submucosa harboring a variable risk of lymph node involvement, which can be estimated through evaluation of morphological, endoscopic, and histologic features. […] Differentiating low- and high-risk histologic features that influence the possibility of residual tumor, the risk of recurrence and the risk of lymph node metastasis, is crucial to further optimize treatment and surveillance plans. […] While the presence of high-risk features indicates a need for surgery in the majority of cases, location, comorbidities and the patients preference should be taken in account when making the final decision. […] The knowledge of identifiable adverse histologic features, the advances in imaging techniques that allow for optical diagnosis of T1 CRC and the recent advances in endoscopic treatment techniques have led to an increasing awareness of the importance of MP.

• #8 Colorectal malignant polyps: a modern approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8713339/

  The presence of high-risk features (positive margin, deep SMI (1 mm), poorly differentiated carcinoma, lymphovascular invasion, tumor budding and piecemeal resection) indicates a need for surgery in the majority of cases, although location, comorbidities and patient preference should be taken into account when making the final decision.

• #9 Colorectal malignant polyps: a modern approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8713339/

  Colorectal malignant polyps (MP) are polyps with invasive cancer into the submucosa harboring a variable risk of lymph node involvement, which can be estimated through evaluation of morphological, endoscopic, and histologic features. […] Differentiating low- and high-risk histologic features that influence the possibility of residual tumor, the risk of recurrence and the risk of lymph node metastasis, is crucial to further optimize treatment and surveillance plans. […] While the presence of high-risk features indicates a need for surgery in the majority of cases, location, comorbidities and the patients preference should be taken in account when making the final decision. […] The knowledge of identifiable adverse histologic features, the advances in imaging techniques that allow for optical diagnosis of T1 CRC and the recent advances in endoscopic treatment techniques have led to an increasing awareness of the importance of MP.

• #10 Long-term survival after treatment of malignant colonic polyps – PubMed

  https://pubmed.ncbi.nlm.nih.gov/9269809/

  Purpose: This study was designed to evaluate the long-term outcome and survival of patients treated for malignant colonic polyps. […] Treatment of patients with malignant polyps must be individualized based on evolving criteria. Patients in whom polypectomy margins are inadequate should undergo colectomy. With appropriate selection criteria, patients selected for colectomy had a five-year survival rate similar to the rate of those treated by polypectomy alone.

• #11 Long-term survival after treatment of malignant colonic polyps – PubMed

  https://pubmed.ncbi.nlm.nih.gov/9269809/

  Purpose: This study was designed to evaluate the long-term outcome and survival of patients treated for malignant colonic polyps. […] Treatment of patients with malignant polyps must be individualized based on evolving criteria. Patients in whom polypectomy margins are inadequate should undergo colectomy. With appropriate selection criteria, patients selected for colectomy had a five-year survival rate similar to the rate of those treated by polypectomy alone.

• #12 They found colon polyps: Now what? – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/they-found-colon-polyps-now-what

  Follow-up exams at the right time are essential to prevent cancer from developing. […] Colorectal cancer is one of the most preventable forms of cancer if you are screened for hidden warning signs while you are still healthy. […] They are not cancer, and most of them have not started to change into cancer. […] If you get them at the precancerous phase, they don’t have a chance to grow and turn into cancer. […] Overall, only 5% of adenomas progress to cancer, but your individual risk is hard to predict. […] There is a 25% to 30% chance that a repeat colonoscopy will find additional polyps. […] How soon you need to return for follow-up depends largely on the size of the polyps found in the first exam. […] If the colonoscopy finds one or two small polyps (5 mm in diameter or smaller), you are considered at relatively low risk.

• #13 They found colon polyps: Now what? – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/they-found-colon-polyps-now-what

  Follow-up exams at the right time are essential to prevent cancer from developing. […] Colorectal cancer is one of the most preventable forms of cancer if you are screened for hidden warning signs while you are still healthy. […] They are not cancer, and most of them have not started to change into cancer. […] If you get them at the precancerous phase, they don’t have a chance to grow and turn into cancer. […] Overall, only 5% of adenomas progress to cancer, but your individual risk is hard to predict. […] There is a 25% to 30% chance that a repeat colonoscopy will find additional polyps. […] How soon you need to return for follow-up depends largely on the size of the polyps found in the first exam. […] If the colonoscopy finds one or two small polyps (5 mm in diameter or smaller), you are considered at relatively low risk.

• #14 They found colon polyps: Now what? – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/they-found-colon-polyps-now-what

  If the polyps are larger (10 mm or larger), more numerous, or abnormal in appearance under a microscope, you may have to return in three years or sooner. […] If the exam finds no polyps, you can usually wait 10 years for the next screening if you are at average risk for colon cancer. […] For colonoscopy to prevent cancer, the doctor must find and remove as many precancerous growths as possible. […] After polyp removal, certain steps may lower your risk of colon cancer.

• #15 Construction and validation of machine learning-based predictive model for colorectal polyp recurrence one year after endoscopic mucosal resection

  https://www.wjgnet.com/1007-9327/full/v31/i11/102387.htm

  Colorectal polyps are precancerous diseases of colorectal cancer. Early detection and resection of colorectal polyps can effectively reduce the mortality of colorectal cancer. Endoscopic mucosal resection (EMR) is a common polypectomy procedure in clinical practice, but it has a high postoperative recurrence rate. Currently, there is no predictive model for the recurrence of colorectal polyps after EMR. […] To construct and validate a machine learning (ML) model for predicting the risk of colorectal polyp recurrence one year after EMR. […] Multivariate logistic regression analysis identified 8 independent risk factors for colorectal polyp recurrence one year after EMR (P 0.05). Among the models, eXtreme Gradient Boosting (XGBoost) demonstrated the highest area under the curve (AUC) in the training set, internal validation set, and prospective validation set, with AUCs of 0.909 (95%CI: 0.89-0.92), 0.921 (95%CI: 0.90-0.94), and 0.963 (95%CI: 0.94-0.99), respectively.

• #16 Construction and validation of machine learning-based predictive model for colorectal polyp recurrence one year after endoscopic mucosal resection

  https://www.wjgnet.com/1007-9327/full/v31/i11/102387.htm

  Colorectal polyps are precancerous diseases of colorectal cancer. Early detection and resection of colorectal polyps can effectively reduce the mortality of colorectal cancer. Endoscopic mucosal resection (EMR) is a common polypectomy procedure in clinical practice, but it has a high postoperative recurrence rate. Currently, there is no predictive model for the recurrence of colorectal polyps after EMR. […] To construct and validate a machine learning (ML) model for predicting the risk of colorectal polyp recurrence one year after EMR. […] Multivariate logistic regression analysis identified 8 independent risk factors for colorectal polyp recurrence one year after EMR (P 0.05). Among the models, eXtreme Gradient Boosting (XGBoost) demonstrated the highest area under the curve (AUC) in the training set, internal validation set, and prospective validation set, with AUCs of 0.909 (95%CI: 0.89-0.92), 0.921 (95%CI: 0.90-0.94), and 0.963 (95%CI: 0.94-0.99), respectively.

• #17 Construction and validation of machine learning-based predictive model for colorectal polyp recurrence one year after endoscopic mucosal resection

  https://www.wjgnet.com/1007-9327/full/v31/i11/102387.htm

  The XGBoost model has the best predictive performance and can assist clinicians in providing individualized colonoscopy follow-up recommendations. […] This study is the first to use machine learning methods to construct and validate a prediction model for one year recurrence of colorectal polyps after endoscopic mucosal resection. Key predictors included age, smoking, family history, diarrhea, hazard classification, Helicobacter pylori infection, number and size of polyps. […] The eight feature variables mentioned above were incorporated into the model construction. In the training set, the ROC-AUC values of the prediction models built using five ML algorithms are shown in Figure 2A: LR (AUC = 0.803, 95%CI: 0.779-0.828), DT (AUC = 0.754, 95%CI: 0.728-0.781), RF (AUC = 0.861, 95%CI: 0.84-0.881), SVM (AUC = 0.808, 95%CI: 0.784-0.832), and XGBoost (AUC = 0.909, 95%CI: 0.893-0.925).

• #18 Construction and validation of machine learning-based predictive model for colorectal polyp recurrence one year after endoscopic mucosal resection

  https://www.wjgnet.com/1007-9327/full/v31/i11/102387.htm

  The clinical applicability of the XGBoost model was assessed using DCA. […] This study is the first to develop ML models to predict the recurrence of colorectal polyps one year after EMR and to identify associated risk factors. Among these models, the XGBoost model performed the best. Additionally, we developed an online web calculator based on the XGBoost predictions, which can help clinicians quickly calculate a patient’s recurrence risk, facilitating the joint development of appropriate and accurate follow-up plans between clinicians and patients.

• #19 Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden | The BMJ

  https://www.bmj.com/content/373/bmj.n877

  In this nationwide case-control study, individuals with a history of CRC precursor lesions (ie, polyps) in first degree relatives were shown to have a 62% increased risk of CRC compared with those with no family history of polyps. […] The increase in risk was attenuated to 40% after adjusting for family history of CRC but increased to 70-77% when more than one first degree relative had a polyp or when a polyp was first diagnosed in a first degree relative before age 50 years. […] A particularly strong association was found for early onset CRC. […] These findings provide robust evidence for the impact of family history of polyps on risk of CRC and have important implications for CRC screening.

• #20 Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden | The BMJ

  https://www.bmj.com/content/373/bmj.n877

  In this nationwide case-control study, individuals with a history of CRC precursor lesions (ie, polyps) in first degree relatives were shown to have a 62% increased risk of CRC compared with those with no family history of polyps. […] The increase in risk was attenuated to 40% after adjusting for family history of CRC but increased to 70-77% when more than one first degree relative had a polyp or when a polyp was first diagnosed in a first degree relative before age 50 years. […] A particularly strong association was found for early onset CRC. […] These findings provide robust evidence for the impact of family history of polyps on risk of CRC and have important implications for CRC screening.

• #21 Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden | The BMJ

  https://www.bmj.com/content/373/bmj.n877

  Objective To assess the risk of colorectal cancer (CRC) in first degree relatives (parents and full siblings) of patients with precursor lesions (polyps) for CRC. […] After adjusting for family history of CRC and other covariates, having a first degree relative with a colorectal polyp was associated with a higher risk of CRC (odds ratio 1.40, 95% confidence interval 1.35 to 1.45). […] A particularly strong association was found for early onset CRC diagnosed before age 50 years (2 first degree relatives: 3.34, 2.05 to 5.43). […] After adjusting for family history of CRC, the siblings and children of patients with colorectal polyps are still at higher risk of CRC, particularly early onset CRC. Early screening for CRC might be considered for first degree relatives of patients with polyps.

• #22 Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-11-65

  Current evidence suggests that the common practice of performing colonoscopies to identify cancers in people with bowel symptoms is warranted only for rectal bleeding and the general symptom of weight loss. […] Overall, only bleeding and weight loss showed any significant association with cancer. […] The symptoms usually considered important for colorectal cancer diagnosis are rectal bleeding, change in bowel habit, abdominal pain, weight loss, diarrhoea and constipation. Of these, in our systematic review, only weight loss and rectal bleeding were associated with colorectal cancer, albeit with low DORs and AUCs. […] Our systematic review has shown that, on current evidence, only rectal bleeding and the general symptom of weight loss are associated with colorectal cancer, and may be helpful in selecting patients for further investigation with colonoscopy.

• #23 Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-11-65

  Current evidence suggests that the common practice of performing colonoscopies to identify cancers in people with bowel symptoms is warranted only for rectal bleeding and the general symptom of weight loss. […] Overall, only bleeding and weight loss showed any significant association with cancer. […] The symptoms usually considered important for colorectal cancer diagnosis are rectal bleeding, change in bowel habit, abdominal pain, weight loss, diarrhoea and constipation. Of these, in our systematic review, only weight loss and rectal bleeding were associated with colorectal cancer, albeit with low DORs and AUCs. […] Our systematic review has shown that, on current evidence, only rectal bleeding and the general symptom of weight loss are associated with colorectal cancer, and may be helpful in selecting patients for further investigation with colonoscopy.

• #24 Colon Polyp Size Chart: What’s Cancerous, What’s Not

  https://www.verywellhealth.com/colon-polyp-size-chart-8659874

  FAP typically causes hundreds of colon polyps, and people with this condition have nearly a 100% chance of developing colorectal cancer, usually by the time they reach age 50. […] The size of a colorectal polyp is one of several important factors in determining the risk of the polyp becoming cancerous. Generally speaking, polyps 10 mm or bigger are more likely to become cancerous than those smaller than 10 mm, but this can vary depending on other characteristics, such as the type of polyp. […] Early detection and removal of colorectal polyps can reduce your chances of developing colorectal cancer.

• #25 They found colon polyps: Now what? – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/they-found-colon-polyps-now-what

  If the polyps are larger (10 mm or larger), more numerous, or abnormal in appearance under a microscope, you may have to return in three years or sooner. […] If the exam finds no polyps, you can usually wait 10 years for the next screening if you are at average risk for colon cancer. […] For colonoscopy to prevent cancer, the doctor must find and remove as many precancerous growths as possible. […] After polyp removal, certain steps may lower your risk of colon cancer.

• #26 Colon Polyp Size Chart: What’s Cancerous, What’s Not

  https://www.verywellhealth.com/colon-polyp-size-chart-8659874

  FAP typically causes hundreds of colon polyps, and people with this condition have nearly a 100% chance of developing colorectal cancer, usually by the time they reach age 50. […] The size of a colorectal polyp is one of several important factors in determining the risk of the polyp becoming cancerous. Generally speaking, polyps 10 mm or bigger are more likely to become cancerous than those smaller than 10 mm, but this can vary depending on other characteristics, such as the type of polyp. […] Early detection and removal of colorectal polyps can reduce your chances of developing colorectal cancer.

• #27 Colon Polyp Size Chart: What’s Cancerous, What’s Not

  https://www.verywellhealth.com/colon-polyp-size-chart-8659874

  FAP typically causes hundreds of colon polyps, and people with this condition have nearly a 100% chance of developing colorectal cancer, usually by the time they reach age 50. […] The size of a colorectal polyp is one of several important factors in determining the risk of the polyp becoming cancerous. Generally speaking, polyps 10 mm or bigger are more likely to become cancerous than those smaller than 10 mm, but this can vary depending on other characteristics, such as the type of polyp. […] Early detection and removal of colorectal polyps can reduce your chances of developing colorectal cancer.

• #28 Colorectal malignant polyps: a modern approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8713339/

  Colorectal malignant polyps (MP) are polyps with invasive cancer into the submucosa harboring a variable risk of lymph node involvement, which can be estimated through evaluation of morphological, endoscopic, and histologic features. […] Differentiating low- and high-risk histologic features that influence the possibility of residual tumor, the risk of recurrence and the risk of lymph node metastasis, is crucial to further optimize treatment and surveillance plans. […] While the presence of high-risk features indicates a need for surgery in the majority of cases, location, comorbidities and the patients preference should be taken in account when making the final decision. […] The knowledge of identifiable adverse histologic features, the advances in imaging techniques that allow for optical diagnosis of T1 CRC and the recent advances in endoscopic treatment techniques have led to an increasing awareness of the importance of MP.

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