Removing Premalignant Lesions Cuts Colorectal Cancer Risk

Endoscopic removal of premalignant lesions decreased the long-term risk of colorectal cancer (CRC) by 86%, according to study results published online ahead of print in Clinical Gastroenterology and Hepatology. 

The prospective cohort study included 1895 participants from the Japan Polyp Study, which spanned 11 institutions in Japan. After a 2-round baseline colonoscopy process, study participants underwent an average 2.8 scheduled follow-up colonoscopies over a median 6.1 years.

According to the study, 4 patients — all of whom were male — developed CRC over follow-up.

The observed/expected ratio of CRC, which researchers calculated using data from the population-based Osaka Cancer Registry, was 0.14 for all participants, reflecting an 86% risk reduction, the study found. In men, the observed/expected ratio of CRC was 0.18. In women, it was 0.

A total 77 advanced neoplasias were detected in 71 patients. Among them, 40.3% were laterally spreading tumors, nongranular type, and 59.7% were nonpolypoid colorectal neoplasms, including flat, depressed, and laterally spreading lesions. Two of the 4 patients who developed CRC had T1 nonpolypoid colorectal neoplasms.

“Endoscopic removal of premalignant lesions, including nonpolypoid colorectal neoplasms, effectively reduced CRC risk,” researchers concluded. “More than half of metachronous advanced neoplasias removed by surveillance colonoscopy were nonpolypoid colorectal neoplasms.”

Reference
Sano Y, Hotta K, Matsuda T, et al. Endoscopic removal of premalignant lesions reduces long-term colorectal cancer risk: results from the Japan Polyp Study. Clin Gastroenterol Hepatol. Published online August 4, 2023. doi: 10.1016/j.cgh.2023.07.021