Transition from polyp to cancer age-dependent

Thu Nov 22, 12:36 PM ET
Men and women with advanced colorectal polyps have a similar risk of progressing to colorectal cancer (CRC) and the risk increases with age in both sexes, according to a study conducted in Germany.
Colorectal polyps (also called adenomas) are found in up to 40 percent of adults over 50. Fewer than 5 percent of them turn cancerous.
To come up with age- and sex-specific estimates of transition rates from advanced polyps to CRC, Dr. Hermann Brenner from the German Cancer Research Center, Heidelberg and colleagues used combined data from 840,149 screening colonoscopies and from national population-based cancer registries.
They report in the journal Gut that annual transition rates increase from 2.6 percent in women aged 55 to 59 years to 5.6 percent in women aged 80 and older. For men in these age groups, transition rates increase from 2.6 percent to 5.1 percent.
In their analyses, estimates of 10-year cumulative risk increased from 25.4 percent at age 55 years to 42.9 percent at age 80 years in women, with corresponding increases from 25.2 percent to 39.7 percent in men.
"Our finding that advanced adenoma transition rates are strongly age-dependent could have important clinical implications, possibly including a higher age at first screening or differential endoscopy intervals according to age," Brenner and colleagues write.
"However, additional risk factors, such as family history of CRC, also have to be taken into account," they note.
SOURCE: Gut, November 2007.