The American Journal of Medicine
Volume 122, Issue 7 , Pages 687.e1-687.e9 , July 2009

Management of Small Polyps Detected by Screening CT Colonography: Patient and Physician Preferences

  • Jessica P. Shah, MD

      Affiliations

    • Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas
  • ,
  • Linda S. Hynan, PhD

      Affiliations

    • Department of Clinical Sciences (Biostatistics), University of Texas Southwestern Medical Center, Dallas
  • ,
  • Don C. Rockey, MD

      Affiliations

    • Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas
    • Corresponding Author InformationRequests for reprints should be addressed to Don C. Rockey, MD, University of Texas Southwestern Medical Center, Division of Digestive and Liver Diseases, 5323 Harry Hines Blvd, Dallas, TX 75390-8887

References 

  1. Ries LA, Wingo PA, Miller DS, et al. The annual report to the nation on the status of cancer, 1973-1997, with a special section on colorectal cancer. Cancer. 2000;88:2398–2424
  2. Morson BC. Evolution of cancer of the colon and rectum. Cancer. 1974;34(Suppl):845–849
  3. Bond JH. Clinical evidence for the adenoma-carcinoma sequence, and the management of patients with colorectal adenomas. Semin Gastrointest Dis. 2000;11:176–184
  4. Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy (The National Polyp Study Workgroup). N Engl J Med. 1993;329:1977–1981
  5. Winawer SJ, Zauber AG, Fletcher RH, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. CA Cancer J Clin. 2006;56:143–159quiz 184-185
  6. Zauber AG, Winawer SJ. Initial management and follow-up surveillance of patients with colorectal adenomas. Gastroenterol Clin North Am. 1997;26:85–101
  7. Muller AD, Sonnenberg A. Prevention of colorectal cancer by flexible endoscopy and polypectomy: a case-control study of 32,702 veterans. Ann Intern Med. 1995;123:904–910
  8. Sampliner RE, Garewal HS. Endoscopic polypectomy reduces mortality from colorectal cancer. Arch Intern Med. 1995;155:1711–1712
  9. Levin B, Lieberman DA, McFarland B, et al. Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130–160Epub 2008 Mar 5
  10. Rockey DC, Paulson E, Niedzwiecki D, et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet. 2005;365:305–311
  11. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med. 2003;349:2191–2200
  12. Cotton PB, Durkalski VL, Pineau BC, et al. Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA. 2004;291:1713–1719
  13. O'Brien MJ, Winawer SJ, Zauber AG, et al. The National Polyp Study (Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas). Gastroenterology. 1990;98:371–379
  14. Shinya H, Wolff WI. Morphology, anatomic distribution and cancer potential of colonic polyps. Ann Surg. 1979;190:679–683
  15. Read TE, Read JD, Butterly LF. Importance of adenomas 5 mm or less in diameter that are detected by sigmoidoscopy. N Engl J Med. 1997;336:8–12
  16. Butterly LF, Chase MP, Pohl H, Fiarman GS. Prevalence of clinically important histology in small adenomas. Clin Gastroenterol Hepatol. 2006;4:343–348
  17. Gschwantler M, Kriwanek S, Langner E, et al. High-grade dysplasia and invasive carcinoma in colorectal adenomas: a multivariate analysis of the impact of adenoma and patient characteristics. Eur J Gastroenterol Hepatol. 2002;14:183–188
  18. Zalis ME, Barish MA, Choi JR, et al. CT colonography reporting and data system: a consensus proposal. Radiology. 2005;236:3–9
  19. Pickhardt PJ, Taylor AJ, Kim DH, et al. Screening for colorectal neoplasia with CT colonography: initial experience from the 1st year of coverage by third-party payers. Radiology. 2006;241:417–425
  20. Pickhardt PJ, Hassan C, Laghi A, et al. Small and diminutive polyps detected at screening CT colonography: a decision analysis for referral to colonoscopy. AJR Am J Roentgenol. 2008;190:136–144
  21. Pickhardt PJ, Hassan C, Laghi A, et al. Cost-effectiveness of colorectal cancer screening with computed tomography colonography: the impact of not reporting diminutive lesions. Cancer. 2007;109:2213–2221
  22. Rex DK, Lieberman D. ACG colorectal cancer prevention action plan: update on CT-colonography. Am J Gastroenterol. 2006;101:1410–1413
  23. van Dam J, Cotton P, Johnson CD, et al. AGA future trends report: CT colonography. Gastroenterology. 2004;127:970–984
  24. Heidorn K. Hailstone Size Categories. 2002. http://www.islandnet.com/∽see/weather/eyes/hailsize.htmLast accessed October 20, 2007.
  25. Ros G, Rincon F. Changes in some constituents of pea seed during commercial canning. Plant Foods Hum Nutr. 1993;43:233–240
  26. Braddock CH, Fihn SD, Levinson W, et al. How doctors and patients discuss routine clinical decisions (Informed decision making in the outpatient setting). J Gen Intern Med. 1997;12:339–345
  27. Green CA, Pope CR. Gender, psychosocial factors and the use of medical services: a longitudinal analysis. Soc Sci Med. 1999;48:1363–1372
  28. Kim DH, Pickhardt PJ, Taylor AJ, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med. 2007;357:1403–1412
  29. Davis RE, Koutantji M, Vincent CA. How willing are patients to question healthcare staff on issues related to the quality and safety of their healthcare? (An exploratory study). Qual Saf Health Care. 2008;17:90–96
  30. Hur C, Chung DC, Schoen RE, Gazelle GS. The management of small polyps found by virtual colonoscopy: results of a decision analysis. Clin Gastroenterol Hepatol. 2007;5:237–244
  31. Park SH, Ha HK, Kim MJ, et al. False-negative results at multi-detector row CT colonography: multivariate analysis of causes for missed lesions. Radiology. 2005;235:495–502
  32. Park SH, Lee SS, Choi EK, et al. Flat colorectal neoplasms: definition, importance, and visualization on CT colonography. AJR Am J Roentgenol. 2007;188:953–959
  33. Cummings SR, Stewart AL, Hulley SB. Designing questionnaires and data collection instruments. In:  Hulley SB,  Cummings SR,  Browner WS editor. Designing Clinical Research. 2nd ed.. Philadelphia: Lippincott Williams & Wilkins; 2001;p. 241–255
  34. Kaplowitz MD, Hadlock TD, Levine R. A comparison of web and mail survey response rates. Public Opin Q. 2004;68:94–101

 Funding: Dr Shah was supported in part by a National Institutes of Health research grant (NIH T32-DK07745).

 Conflict of Interest: None.

 Authorship: All authors had access to the data and played a role in writing this manuscript.

PII: S0002-9343(09)00285-X

doi: 10.1016/j.amjmed.2009.01.028

The American Journal of Medicine
Volume 122, Issue 7 , Pages 687.e1-687.e9 , July 2009