Moon CM, et al. - The clinical impact of diminutive or small adenomas at baseline on the risk of developing metachronous advanced colorectal neoplasia (CRN) was investigated. Researchers noted no clinical significance of multiplicity of diminutive tubular adenomas (TAs), without advanced lesions, for risk of developing metachronous advanced CRN.

Methods

• Researchers performed a multicenter, retrospective cohort study including 2,252 patients with 1 or more colorectal adenomas at baseline and subsequent follow-up colonoscopy.
• They classified baseline colonoscopy findings into 5 groups: 1 or 2 TAs (<10 mm); 3–10 diminutive TAs (≤5 mm); 3–10 TAs, including 1 or 2 small adenomas (6–10 mm); 3–10 TAs, including 3 or more small adenomas; and advanced adenoma.

Results

• Multivariate analysis suggested that 3–10 TAs including 3 or more small adenomas (hazard ratio [HR] = 2.36, p=0.034) and advanced adenoma (HR = 2.14, p < 0.001) were independent predictors for the risk of developing metachronous advanced CRN after adjusting for possible confounding variables (age at baseline, sex, body mass index, smoking habits, family history of colorectal cancer, regular use of aspirin or NSAIDs, and adenoma location).
• However, 3–10 diminutive TAs or 3–10 TAs, including 1 or 2 small adenomas, were not observed to be associated with this outcome.