National Polyp Study data: evidence for regression of adenomas

Int J Cancer. 2004 Sep 10;111(4):633-9. doi: 10.1002/ijc.20277.


The data of the National Polyp Study, a large longitudinal study on surveillance of adenoma patients, is used for testing assumptions on the adenoma-carcinoma sequence. The observed adenoma and colorectal cancer incidence in the National Polyp Study were compared with the simulated outcomes of the MISCAN-COLON model of epidemiology and control of colorectal cancer for the U.S. population based on expert opinion. Variants of this model were explored in order to identify assumptions on the adenoma-carcinoma sequence that are consistent with the study observations. The high observed adenoma detection rates at surveillance and low observed colorectal cancer incidence in the National Polyp Study could only be explained by assuming a high incidence rate of adenomas accompanied by regression of adenomas. The National Polyp Study data suggest that adenoma prevalence results from a dynamic process of both formation as well as regression of adenomas. This lowers the expectations for the effects of colorectal cancer screening strategies that focus on adenoma detection.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenoma / epidemiology*
  • Adenoma / physiopathology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Colonic Polyps / epidemiology*
  • Colonic Polyps / physiopathology*
  • Colonoscopy*
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / physiopathology*
  • Female
  • Health Surveys
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Population Surveillance*
  • Precancerous Conditions / epidemiology*
  • Prevalence