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Early Detection and Prevention of Colon Cancer: The Role of Colonoscopy

Early Detection and Prevention of Colon Cancer: The Role of Colonoscopy Abstract The incidence of and mortality associated with colon cancer has not decreased during the past 25 years despite several innovations in therapy. Earlier detection and prevention by polypectomy through the sigmoidoscope and colonoscope have been suggested as one alternative offering improvement. The polyp-cancer sequence is controversial, but recent evidence indicates that polyps with a papillary component have a substantial potential for becoming malignant. Fortyfour polyps were resected from 26 patients. Nineteen polyps from 14 patients had papillary features or "in-situ" carcinoma. Thus, colonoscopic polypectomy may play an important role not only in early detection but also in the prevention of colon cancer. (Arch Intern Med 136:890-892, 1976) References 1. Silverberg E, Holleb AI: Major trends in cancer: 25-year survey . CA 26:1-7, 1975. 2. Turnbull RB, Kyle K, Watson FR, et al: Cancer of the colon: The influence of the no-touch technique on survival rates . Ann Surg 166:420-425, 1967.Crossref 3. Ruff CC, Dockerty MB, Fricke RE, et al: Preoperative radiation therapy for adenocarcinoma of the rectum and rectosigmoid . Surg Gynecol Obstet 112:215-223, 1961. 4. Rousselot LM, Cole DR, Grossi CE, et al: Intraluminal chemotherapy adjuvant to operation for cancer of the colon and rectum: II. Follow-up report of 97 cases . Cancer 20:829-833, 1967.Crossref 5. Higgins GA, Dwight RW, Smith JV, et al: Flurouracil as an adjuvant to surgery in carcinoma of the colon . Arch Surg 102:339-343, 1971.Crossref 6. Gilbertsen VA: Proctosigmoidoscopy and polypectomy in reducing the incidence of rectal cancer . Cancer 34:936-939, 1974.Crossref 7. Shatney CH, Lober PH, Gilbertsen VA, et al: The treatment of pedunculated adenomatous colorectal polyps with focal cancer . Surg Gynecol Obstet 139:845-850, 1974. 8. Wolff WI, Shinya H: Earlier diagnosis of cancer of the colon through colonic endoscopy (colonoscopy) . Cancer 34:912-931, 1974.Crossref 9. Kurzon RM, Ortega R, Rywlin AM: The significance of papillary features in polyps of the large intestine . Am J Clin Pathol 62:447-454, 1974. 10. Arminski TC, McLean DW: Incidence and distribution of adenomatous polyps of the colon and rectum based on 1,000 autopsy examinations . Dis Colon Rectum 7:249-261, 1964.Crossref 11. Wolff WI, Shinya H: Polypectomy via the fiberoptic colonoscope: Removal of neoplasms beyond the reach of the sigmoidoscope . N Engl J Med 28:329-332, 1973.Crossref 12. Curtiss LE: High frequency currents in endoscopy: A review of principles and precautions . Gastrointest Endosc 20:9-12, 1973.Crossref 13. Nicoloff DM, Ellis CM, Humphrey EW: Management of villous adenomas of the colon and rectum . Arch Surg 97:254-259, 1968.Crossref 14. Morson BC, Bussey HJR: Predisposing causes of intestinal cancer . Curr Probl Surg 1-46, (Feb) 1970. 15. Castleman B, Krickstein HI: Do adenomatous polyps of the colon become malignant? N Engl J Med 267:469-475, 1962.Crossref 16. Buntain WL, ReMine WH, Farrow GM: Premalignancy of polyps of the colon . Surg Gynecol Obstet 134:499-508, 1972. 17. Fung CHK, Goldman H: The incidence and significance of villous change in adenomatous polyps . Am J Clin Pathol 53:21-25, 1971. 18. Morson BC, Pang LSC: Rectal biopsy as an aid to cancer control in ulcerative colitis . Gut 8:423-434, 1967.Crossref 19. Yardley JH, Keren DF: "Pancancer" lesions in ulcerative colitis . Cancer 34:835-844, 1974.Crossref 20. Welch CE: Polypoid Lesions of the Gastrointestinal Tract . Philadelphia, WB Saunders Co, 1964. 21. Swinton NW, Weakley FL: Complications of colotomy and colonoscopy . Dis Colon Rectum 6:50-53, 1963.Crossref 22. Klanfeld G, Gump FE: Complications of colotomy and polypectomy . Surg Gynecol Obstet 111:726-728, 1960. 23. Berci G, Parish JF, Schapiro M, et al: Complications of colonoscopy and polypectomy: Report of the Southern California Society for Gastrointestinal Endoscopy . Gastroenterology 67:584-585, 1974. 24. Carter HG: Explosion in colon during electrodesiccation of polyps . Am J Surg 84:514-516, 1952.Crossref 25. Ragins H, Shinya H, Wolff WI: The explosive potential of colonic gas during colonoscopic electrosurgical polypectomy . Surg Gynecol Obstet 138:554-556, 1974. 26. Wolff WI, Shinya H: A new approach to the management of colonic polyps . Adv Surg 7:45-67, 1973. 27. Quan SHQ, Castro EB: Papillary adenomas (villous tumors): A review of 215 cases . Dis Colon Rectum 14:267-280, 1971.Crossref 28. Knutson CO, Schrock LG, Polk HC: Polypoid lesions of the proximal colon: Comparison of experience with removal at laparotomy and by colonoscopy . Ann Surg 179:657-661, 1974.Crossref 29. Bloom BS, Goldhaver SZ, Sugarbaker PH, et al: Fiberoptics: Morbidity and cost . N Engl J Med 288:368, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Early Detection and Prevention of Colon Cancer: The Role of Colonoscopy

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1976.03630080032011
Publisher site
See Article on Publisher Site

Abstract

Abstract The incidence of and mortality associated with colon cancer has not decreased during the past 25 years despite several innovations in therapy. Earlier detection and prevention by polypectomy through the sigmoidoscope and colonoscope have been suggested as one alternative offering improvement. The polyp-cancer sequence is controversial, but recent evidence indicates that polyps with a papillary component have a substantial potential for becoming malignant. Fortyfour polyps were resected from 26 patients. Nineteen polyps from 14 patients had papillary features or "in-situ" carcinoma. Thus, colonoscopic polypectomy may play an important role not only in early detection but also in the prevention of colon cancer. (Arch Intern Med 136:890-892, 1976) References 1. Silverberg E, Holleb AI: Major trends in cancer: 25-year survey . CA 26:1-7, 1975. 2. Turnbull RB, Kyle K, Watson FR, et al: Cancer of the colon: The influence of the no-touch technique on survival rates . Ann Surg 166:420-425, 1967.Crossref 3. Ruff CC, Dockerty MB, Fricke RE, et al: Preoperative radiation therapy for adenocarcinoma of the rectum and rectosigmoid . Surg Gynecol Obstet 112:215-223, 1961. 4. Rousselot LM, Cole DR, Grossi CE, et al: Intraluminal chemotherapy adjuvant to operation for cancer of the colon and rectum: II. Follow-up report of 97 cases . Cancer 20:829-833, 1967.Crossref 5. Higgins GA, Dwight RW, Smith JV, et al: Flurouracil as an adjuvant to surgery in carcinoma of the colon . Arch Surg 102:339-343, 1971.Crossref 6. Gilbertsen VA: Proctosigmoidoscopy and polypectomy in reducing the incidence of rectal cancer . Cancer 34:936-939, 1974.Crossref 7. Shatney CH, Lober PH, Gilbertsen VA, et al: The treatment of pedunculated adenomatous colorectal polyps with focal cancer . Surg Gynecol Obstet 139:845-850, 1974. 8. Wolff WI, Shinya H: Earlier diagnosis of cancer of the colon through colonic endoscopy (colonoscopy) . Cancer 34:912-931, 1974.Crossref 9. Kurzon RM, Ortega R, Rywlin AM: The significance of papillary features in polyps of the large intestine . Am J Clin Pathol 62:447-454, 1974. 10. Arminski TC, McLean DW: Incidence and distribution of adenomatous polyps of the colon and rectum based on 1,000 autopsy examinations . Dis Colon Rectum 7:249-261, 1964.Crossref 11. Wolff WI, Shinya H: Polypectomy via the fiberoptic colonoscope: Removal of neoplasms beyond the reach of the sigmoidoscope . N Engl J Med 28:329-332, 1973.Crossref 12. Curtiss LE: High frequency currents in endoscopy: A review of principles and precautions . Gastrointest Endosc 20:9-12, 1973.Crossref 13. Nicoloff DM, Ellis CM, Humphrey EW: Management of villous adenomas of the colon and rectum . Arch Surg 97:254-259, 1968.Crossref 14. Morson BC, Bussey HJR: Predisposing causes of intestinal cancer . Curr Probl Surg 1-46, (Feb) 1970. 15. Castleman B, Krickstein HI: Do adenomatous polyps of the colon become malignant? N Engl J Med 267:469-475, 1962.Crossref 16. Buntain WL, ReMine WH, Farrow GM: Premalignancy of polyps of the colon . Surg Gynecol Obstet 134:499-508, 1972. 17. Fung CHK, Goldman H: The incidence and significance of villous change in adenomatous polyps . Am J Clin Pathol 53:21-25, 1971. 18. Morson BC, Pang LSC: Rectal biopsy as an aid to cancer control in ulcerative colitis . Gut 8:423-434, 1967.Crossref 19. Yardley JH, Keren DF: "Pancancer" lesions in ulcerative colitis . Cancer 34:835-844, 1974.Crossref 20. Welch CE: Polypoid Lesions of the Gastrointestinal Tract . Philadelphia, WB Saunders Co, 1964. 21. Swinton NW, Weakley FL: Complications of colotomy and colonoscopy . Dis Colon Rectum 6:50-53, 1963.Crossref 22. Klanfeld G, Gump FE: Complications of colotomy and polypectomy . Surg Gynecol Obstet 111:726-728, 1960. 23. Berci G, Parish JF, Schapiro M, et al: Complications of colonoscopy and polypectomy: Report of the Southern California Society for Gastrointestinal Endoscopy . Gastroenterology 67:584-585, 1974. 24. Carter HG: Explosion in colon during electrodesiccation of polyps . Am J Surg 84:514-516, 1952.Crossref 25. Ragins H, Shinya H, Wolff WI: The explosive potential of colonic gas during colonoscopic electrosurgical polypectomy . Surg Gynecol Obstet 138:554-556, 1974. 26. Wolff WI, Shinya H: A new approach to the management of colonic polyps . Adv Surg 7:45-67, 1973. 27. Quan SHQ, Castro EB: Papillary adenomas (villous tumors): A review of 215 cases . Dis Colon Rectum 14:267-280, 1971.Crossref 28. Knutson CO, Schrock LG, Polk HC: Polypoid lesions of the proximal colon: Comparison of experience with removal at laparotomy and by colonoscopy . Ann Surg 179:657-661, 1974.Crossref 29. Bloom BS, Goldhaver SZ, Sugarbaker PH, et al: Fiberoptics: Morbidity and cost . N Engl J Med 288:368, 1973.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1976

References