title: Risk factors for advanced adenomas amongst small and diminutive colorectal polyps: a prospective monocenter study.
abstract: BACKGROUND
  The management of colorectal polyps <10mm in diameter is controversial. Our aim was to evaluate the rate and risk factors for advanced adenomas and high grade neoplasia amongst small (6-9 mm) and diminutive (1-5mm) colorectal polyps.
  
  
  METHODS
  Endoscopic and pathological reports of colonoscopies performed in our centre were collected prospectively. Advanced adenoma was defined by presence of a villous component and/or high grade dysplasia; high grade neoplasia by presence of high grade dysplasia and/or intramucosal carcinoma.
  
  
  RESULTS
  1468 patients were included (53.1% male, mean age 59.5±14 years); 414 polyps <10mm were detected, 9.9% advanced adenomas and 1.7% high grade neoplasia. Amongst small polyps, 25 (35.2%) were advanced adenomas, mainly due to villous features, and 3 (4.2%) were high grade neoplasia. Polyp size was associated with advanced adenomas (odds ratio=8.47).
  
  
  CONCLUSIONS
  The rate of advanced adenomas amongst small polyps was 35%, mainly due to the presence of villous features. Polyp size was identified as a risk factor of advanced adenoma amongst polyps <10mm. Given these results, we believe that polypectomy should be warranted for patients presenting with small polyps at computed tomography colonography.
authors.affiliation: Hepato-gastroenterology Department, CHU Cochin Port-Royal, France.
authors.forename: Ulriikka
authors.initials: U
authors.lastname: Chaput
authors.forename: Sara Folgado
authors.initials: SF
authors.lastname: Alberto
authors.forename: Benoit
authors.initials: B
authors.lastname: Terris
authors.forename: Frederic
authors.initials: F
authors.lastname: Beuvon
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.forename: Herve
authors.initials: H
authors.lastname: Roche
authors.forename: Marianne
authors.initials: M
authors.lastname: Gaudric
authors.forename: Frederic
authors.initials: F
authors.lastname: Prat
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
mesh_terms: D000236:Adenoma / Q000473:pathology*; D000368:Aged; D002277:Carcinoma / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors