The advanced adenoma as the primary target of screening

Gastrointest Endosc Clin N Am. 2002 Jan;12(1):1-9, v. doi: 10.1016/s1052-5157(03)00053-9.


The advanced adenoma bridges benign and malignant states and may be the most valid neoplastic surrogate marker for present and future colorectal cancer risk. We define the advanced adenoma as an adenoma with significant villous features (>25%), size of 1.0 cm or more, high-grade dysplasia, or early invasive cancer. Prevention studies should demonstrate a high efficacy in reducing the number of advanced adenomas. We should use the advanced adenoma in the evaluation of new screening technology, nutritional interventions, and chemoprevention agents because the advanced adenoma is a more desirable target for screening efficacy than is the more uncommon but life-threatening cancer stage or the more common but early, less significant small adenoma stage.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenoma / pathology
  • Adenoma / prevention & control*
  • Cell Transformation, Neoplastic
  • Colonoscopy
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / prevention & control*
  • Disease Progression
  • Humans
  • Mass Screening*