Phenotypic characteristics and risk of cancer development in hyperplastic polyposis: case series and literature review

Am J Gastroenterol. 2004 Oct;99(10):2012-8. doi: 10.1111/j.1572-0241.2004.30021.x.


Objectives: Hyperplastic polyposis (HP) is a poorly understood condition. The aim of this study is to describe the phenotype and the risk of cancer in HP.

Methods: Patients with HP, as defined by the WHO International Classification, were identified through the University of Utah and the Huntsman Cancer Institute databases. Family history was retrieved when possible.

Results: Fifteen patients were identified (10 M, 5 F) with a mean age at diagnosis of 52.6 +/- 16.4 yr (18-71). Sixty-five colonoscopies were performed (2-11 per person). A median of 90 polyps (16-210) per person and 15 polyps (range, 0-100) per procedure were reported. The median follow-up was 33 months (3-133); no cancer occurred during this period. Polyps were more frequent in the distal than the proximal colon (74%vs 26%; p < 0.001). The median polyp size was 4 mm (1-40 mm). Fifty-one hyperplastic polyps >10 mm were identified in 10 patients (38 proximal, 13 distal; p= 0.089). Forty-eight adenomas were found in 11 patients and were uniformly distributed. Serrated adenomas (n = 3) were found in one patient. A unique patient had 20 large hyperplastic polyps, 24 adenomas, 3 serrated adenomas, and 118 hyperplastic polyps. None of the patients had a first-degree relative with colon cancer.

Conclusions: In HP, hyperplastic polyps are more frequently distal colonic, and vary greatly in size and number. Most patients also develop adenomas that are distributed throughout the colon. No cancers developed within 3 yr of follow-up. Colonoscopic surveillance at intervals of 1-3 yr, depending upon the number and size of both adenomatous and hyperplastic polyps, appears prudent.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Colonic Neoplasms / epidemiology
  • Colonic Neoplasms / genetics*
  • Colonic Polyps / genetics*
  • Colonic Polyps / pathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phenotype
  • Risk Factors