Hyperplastic polyps and the risk of adenoma recurrence in the polyp prevention trial.
OBJECTIVE
Recent studies have suggested that some hyperplastic polyps may be associated with an increased risk of colorectal cancer. Prospective information on the risk of adenoma recurrence associated with hyperplastic polyps is limited. We sought to investigate whether the coexistence of hyperplastic polyps with adenomas increases the risk of adenoma recurrence.


METHODS
We used unconditional logistic regression models to examine the association between baseline hyperplastic polyps and subsequent adenoma recurrence during a 3-year follow-up evaluation, among 1637 participants in the Polyp Prevention Trial.


RESULTS
A total of 437 participants (26.7%) had hyperplastic polyps coexisting with adenomas at baseline. Of these, 132 (30.2%) had at least one hyperplastic polyp in the proximal colon, whereas 305 (69.8%) had only distal hyperplastic polyps. When compared with subjects without any hyperplastic polyps at baseline, there was no statistically significant association between the presence of baseline hyperplastic polyps and recurrence of any adenoma (odds ratio [OR], 1.19; 95% confidence interval [CI], 0.94-1.51) or advanced adenoma (OR, 1.25; 95% CI, 0.78-2.03). Also, there was no association between hyperplastic polyp location and adenoma recurrence (OR, 1.01; 95% CI, 0.69-1.48) for any proximal hyperplastic polyp (OR, 1.26; 95% CI, 0.96-1.65) and for distal hyperplastic polyps.


CONCLUSIONS
The coexistence of hyperplastic polyps with adenomas, irrespective of location, does not confer an increased risk of adenoma recurrence beyond that of adenomas alone within 3 years of follow-up evaluation. Prospective long-term studies on adenoma recurrence risk associated with hyperplastic polyps in screening populations are needed.
Cancer Prevention Fellowship Program, Office of Preventive Oncology, National Cancer Institute, Bethesda, Maryland 20892, USA. laiyemoa@mail.nih.gov
Adeyinka O
AO
Laiyemo
Gwen
G
Murphy
Leah B
LB
Sansbury
Zhuoqiao
Z
Wang
Paul S
PS
Albert
Pamela M
PM
Marcus
Robert E
RE
Schoen
Amanda J
AJ
Cross
Arthur
A
Schatzkin
Elaine
E
Lanza
D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D000368:Aged; D003111:Colonic Polyps / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors