Colonic Polyps, Cancer, and Fecal Occult Blood
Authors: Jerome B. Simon
Journal: Annals of Internal Medicine (1993)

Editorials1 January 1993Colonic Polyps, Cancer, and Fecal Occult BloodJerome B. Simon, MDJerome B. Simon, MDQueen's University, Kingston, Ontario, K7L 3J7, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-1-199301010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Colorectal polyps are common in the general population over the age of 50.Cancer develops in a small proportion of these lesions, but recent evidence suggests that this may occur less frequently than generally believed and that malignant polyps can behave biologically benign for long periods. Fecal occult blood tests (FOBTs) can help detect subclinical colonic neoplasms but it's not yet clear whether this actually decreases mortality from colorectal cancer. The interrelationships among colonic polyps, cancer, and FOBTs need further study.Everyone agrees that colorectal polyps are common in the general population, that a small proportion are malignant, and that fecal ...References1. Koretz RL. Malignant polyps: are they sheep in wolves' clothing? Ann Intern Med. 1993; 118:63-8. Google Scholar2. Morson BC. Genesis of colorectal cancer. Clin Gastroenterol. 1976; 5:505-25. Google Scholar3. Tierney RP, Ballantyne GH, Modlin IM. The adenoma to carcinoma sequence. Surg Gynecol Obst. 1990; 171:81-94. Google Scholar4. Rex DK, Lehman GA, Hawes RH, Ulbright TM, Smith JJ. Screening colonoscopy in asymptomatic average-risk persons with negative fecal occult blood tests. Gastroenterology. 1991; 100:64-7. Google Scholar5. Lieberman DA, Smith FW. Screening for colon malignancy with colonoscopy. Am J Gastroenterol. 1991; 86:946-51. Google Scholar6. Stryker SJ, Wolff BG, Culp CE, Libbe SD, Ilstrup DM, MacCarty RL. Natural history of untreated colonic polyps. Gastroenterology. 1987; 93:1009-13. Google Scholar7. Atkin WS, Morson BC, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med. 1992; 326:658-62. Google Scholar8. Coverlizza S, Risio M, Ferrari A, Fenoglio-Preiser CM, Rossini FP. Colorectal adenomas containing invasive carcinoma. Pathologic assessment of lymph node metastatic potential. Cancer. 1989; 64:1937-47. Google Scholar9. Selby JV, Friedman GD, Quesenberry CP Jr, Weiss NS. A case–control study of fecal occult blood testing and mortality from colorectal cancer. Ann Intern Med. 1993; 118:1-6. Google Scholar10. Selby JV, Friedman GD, Quesenberry CP Jr, Weiss NS. A case–control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med. 1992; 326:653-7. Google Scholar11. Winawer SJ, Schottenfeld D, Flehinger BJ. Colorectal cancer screening. J Natl Cancer Inst. 1991; 83:243-53. Google Scholar12. Kronberg O, Fenger C, Worm J, Pedersen SA, Hem J, Bertelsen K, et al. Causes of death during the first 5 years of a randomized trial of mass screening for colorectal cancer with fecal occult blood test. Scand J Gastroenterol. 1992; 27:47-52. Google Scholar13. Simon JB. The pros and cons of fecal occult blood testing for colorectal neoplasms. Cancer Metastasis Rev. 1987; 6:397-411. Google Scholar14. Allison JE, Feldman R, Tekawa IS. Hemoccult screening in detecting colorectal neoplasm: sensitivity, specificity, and predictive value. Ann Intern Med. 1990; 112:328-33. Google Scholar15. Ransohoff DF, Lang CA. Small adenomas detected during fecal occult blood test screening for colorectal cancer. The impact of serendipity. JAMA. 1990; 264:76-8. Google Scholar16. Simon JB. Colonic polyps, occult blood, and chance. JAMA. 1990; 264:84-5. Google Scholar17. Knight KK, Fielding JE, Battista RN. U.S. Preventive Services Task Force. Occult blood screening for colorectal cancer. JAMA. 1989; 261:587-93. Google Scholar Author, Article, and Disclosure InformationAffiliations: Queen's University, Kingston, Ontario, K7L 3J7, Canada.Corresponding Author: Jerome B. Simon, MD, Division of Gastroenterology, Queen's University, 78 Barrie Street, Kingston, Ontario K7L 3J7, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMalignant Polyps: Are They Sheep in Wolves' Clothing? Ronald L. Koretz Effect of Fecal Occult Blood Testing on Mortality from Colorectal Cancer: A Case–Control Study Joe V. Selby , Gary D. Friedman , Charles P. Quesenberry, Jr. , and Noel S. Weiss Metrics Cited ByManagement of Cancer in a PolypColorectal cancer: lessons for genetic counselling and care for familiesDouble immunochemical screening test (hemoglobin and albumin) for the detection of occult intestinal bleeding 1 January 1993Volume 118, Issue 1Page: 71-72KeywordsCancer screeningColorectal cancerEpidemiologyFactor analysisHematologic testsLesionsMortalityMucous membranesOdds ratioRetrospective studies Issue Published: 1 January 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...