Adenoma of the Colon and Rectum
Clinical
- Significance of high grade intra-mucosal invasive carcinoma is a subject of current debate (see Grading at left)
- The report of cases exhibiting aggressive behavior suggests that surgical re-excision be considered
- Effect of adenomas on guidelines for screening colonoscopy (Winawer 2006):
- Small rectal hyperplastic polyps
- No change from standard (10 years)
- 1 or 2 tubular adenomas (TA) <1 cm
- Any of the following
- 3-10 TA
- Any TA ≥1 cm
- Any tubulovillous or villous adenoma
- Presence of high grade dysplasia
- Repeat in 3 years
- More than 10 adenomas at one examination
- Repeat in less than 3 years
- Consider familial disorders
- Recommendations may vary based on factors such as:
- Family history
- Adequacy of excisions
- Comorbidities
- Sessile serrated adenomas are counted as TA for screening purposes
