Reviewing the Evidence that Polypectomy Prevents Cancer

Gastrointest Endosc Clin N Am. 2019 Oct;29(4):577-585. doi: 10.1016/j.giec.2019.05.001. Epub 2019 Jul 22.

Abstract

Colonoscopic polypectomy is fundamental to effective prevention of colorectal cancer. Polypectomy reduces colorectal cancer incidence and mortality by altering the natural history and progression of precancerous precursor polyps. Epidemiologic data from the United States, where colorectal cancer rates have been steadily declining in parallel with screening efforts, provide indisputable evidence about the effectiveness of polypectomy. Randomized controlled trials of fecal occult blood tests and flexible sigmoidoscopy, and observational colonoscopy studies, provide additional support. Longitudinal studies have shown variable levels of protection after polypectomy, highlighting the central importance of high quality and adequate surveillance of higher-risk patients.

Keywords: Colonoscopy; Colorectal neoplasms; Polypectomy; Prevention.

Publication types

  • Review

MeSH terms

  • Aged
  • Colonic Polyps / pathology*
  • Colonic Polyps / surgery*
  • Colonoscopy / methods*
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / prevention & control*
  • Evidence-Based Medicine
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Precancerous Conditions / pathology
  • Precancerous Conditions / surgery*
  • Primary Prevention / methods
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • SEER Program
  • Sigmoidoscopy / methods
  • Treatment Outcome
  • United States