Talk:Colorectal polyp

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 November 2018 and 14 December 2018. Further details are available on the course page. Student editor(s): Musc2019. Peer reviewers: Atl201.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 18:04, 16 January 2022 (UTC)

work plan
Week 2 has mostly been using the Sebastian textbook to provide information regarding the different types of polyps classified base on gross anatomy and histology. Most of editing this week involves updating the section on the classification base on gross anatomy and histology. Also made changes to the section on hereditary syndromes such as lynch syndrome and FAP. Their history of discovery, psychopathology, and criteria for diagnosis. Also included was a section on the link between polys and invasive carcinoma and the haggitt's criteria for classification and stratification of risk. The main issue I had this week was not knowing how to properly insert a diagram of haggitt's criteria that I found from a paper from Pubmed. I was not sure about the copyright and whether or not i was allow to use it on my article. The tutorial provided by this course was helpful but I still have some minor questions that hopefully will be addressed during this session. The article is one that I have been using to update my article and here is the link https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780260/#r21286-11. My plan is to complete the section on hereditary syndrome and start working on the prevention and treatment section this week. December 3 2018   — Preceding unsigned comment added by Musc2019 (talk • contribs) 16:45, 3 December 2018 (UTC)

For this article there are limited information provided regarding the structure of the polyps and the syndromes that are associated with the colorectal polyps. The sections that I would like to modify are structure of polyps, many of the genetic syndromes that are associated with polyps. There is no section on the article regarding imaging studies such as endoscopic procedure and it would be good to add that to the article. Signs and symptoms are another area that could be improved upon along with treatment and diagnosis.

Sections to prioritize: -Symptoms and Signs further elaborate on the duration and prevalence of symptoms and signs. -Treatment and Prevention further details regarding various treatment options available and their respective success rates and contraindications. Provide more details regarding recommendation for prevention including lifestyle modifications. Sections to add -Imaging studies provide detail importation regarding the various studies available and their respective sensitivity and specificity. -Associative Genetic Syndromes elaborate on the associated genes and the psychopathology of each syndromes.

For this topic I will be using textbooks such as CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e and Sabiston Textbook of Surgery along with review articles and journals provided through Access Medicine and Clinical Key. These resources are being used currently and I will expect to have more information regarding the topic by the end of this week. I will actively use Access Medicine and Clinical Key along with google search throughout this course to better research the topic. Regarding what things such as signs and symptoms to include and leave out, I will mostly be including things that are pertinent to the topic and by pertinent I mean things that have a strong research results to back the claims. I will also exclude treatments that are still in trial and will only include treatments that have good evidence of success. The two digital textbooks I have included will be new links to the article and I expect to be adding more reference links as I progress. To improve and ensure that the information presented is well written and communicates effectively with the general public, I will mostly be using succinct words, active rather than passive grammars, and using simple to understand terms. I will try to avoid medical jargons and I will utilize resources such as everyday words for public health communication, readability calculator by online utility, and improving health literacy guide by U Michigan. Andy's work plan — Preceding unsigned comment added by Musc2019 (talk • contribs) 20:22, 19 November 2018 (UTC)

11/26/2018

Work plan For this week, I have largely been putting together a list of resources such as textbooks and journal articles on the topic of colorectal polyps. The sections That I have primarily focused on are signs and symptoms, Treatment and prevention. There are still a great deal of research to be done treatment and thus research resources are still lacking. I have mostly been using the textbook, "Essential Surgery: Problems, Diagnosis and Management, Fifth Edition," and the journal, "Gastrointestinal Endoscopy, 2017-07-01, Volume 86, Issue 1, Pages 18-33." I plan to make revision to the signs and symptoms section this weeek. I will continue to work on other sections of the article. — Preceding unsigned comment added by Musc2019 (talk • contribs) 15:13, 26 November 2018 (UTC)

note
SSA/p sessile serrated adenoma /polyp a subtype missing uin this article

Smoking
Pretty unambiguous influence of smoking on polyps: JFW |  T@lk  07:13, 3 February 2008 (UTC)

Merge from colon polyp
I merged the info in colon polyp into this article (colorectal polyp).

Why?
 * Rectal cancer and colon cancer are merged into colorectal cancer.
 * Etiology and classification of polyps in the colon and rectum is not different.
 * It is not always obvious whether a given polyp is rectal or colonic; the landmark between rectum & colon (colorectal junction) is: were the gastrointestinal tract no longer has a serosa about its circumference... this cannot be determined by colonscopy.
 * The management of colonic polyps and rectal polyps is very similar.

Nephron T|C 04:05, 6 April 2009 (UTC)

Evidence based screening
According to the National Guideline Clearinghouse™ (NGC), a public resource for evidence-based clinical practice guidelines.

at

http://www.guideline.gov/summary/summary.aspx?doc_id=14345

[All emphasis added.]

Colorectal cancer screening clinical practice guideline 

MAJOR RECOMMENDATIONS

Definitions of the levels of evidence (evidence-based A-D, I and consensus-based) are provided at the end of the "Major Recommendations" field.

Recommendation 1*: Factors Associated with an Increased Risk of Colorectal Cancer in the General Population

...

Recommendation 2: Effectiveness of Colorectal Cancer Screening Tests

1. Colorectal cancer screening is strongly recommended for all asymptomatic, average-risk adults. (Evidence-based: A) 2. Any of the following tests are acceptable for colorectal cancer screening in asymptomatic, average-risk adults:* 3. The following additional screening tests are either less-preferred options or not recommended for screening. However, an adult who has had one of these tests is considered screened. Follow-up screening using a preferred option is recommended.
 * High-sensitivity' fecal occult blood test (FOBT) (Consensus-based)
 * Immunochemical fecal occult blood test (iFOBT/FIT)** (Consensus-based)
 * Flexible sigmoidoscopy (Evidence-based: B)
 * Colonoscopy** (Consensus-based)
 * A combination of high-sensitivity guaiac FOBT test and flexible sigmoidoscopy (Consensus-based)
 * An annual standard guaiac FOBT is a less-preferred option.*** (Consensus-based)
 * Air contrast barium enema is not recommended as a screening strategy for average-risk adults. (Evidence-based: I)
 * Virtual colonoscopy is not recommended as a screening strategy for average-risk adults.* (Consensus-based)
 * Fecal DNA is not recommended as a screening strategy for average-risk adults.****(Consensus-based)

Note: For fecal blood tests, inform patients of the potential risks associated with false-positive test and false-negative test results, as well as the need for prompt follow-up of a positive test result. For flexible sigmoidoscopy, inform patients that the test has a small risk of complications and is not a complete examination of the entire colon.

*There is insufficient evidence to choose one screening test over another.


 * If a patient has had a normal colonoscopy within the last 10 years, there is insufficient evidence that supplemental FOBT adds any incremental benefit.


 * Even though there is sufficient evidence in support of this screening modality, it is not a preferred option due to its low sensitivity and low compliance rates.


 * Please note that fecal DNA testing and virtual colonoscopy are not listed as "appropriate screening tests" in 2008 HEDIS (Health Plan Employer Data and Information Set) specifications for colorectal cancer screening, and therefore regions may choose to screen members with other appropriate tests.

Recommendation 3: Frequency of Colorectal Cancer Screening

1. The following intervals for colorectal cancer screening in asymptomatic, average-risk adults are recommended*: 2. The following additional screening tests are either less-preferred options or not recommended for screening. However, if these tests are performed, then the recommended intervals are as indicated below. Follow-up screening using a preferred option is recommended.
 * Flexible sigmoidoscopy: at least every 10 years (Consensus-based)
 * High-sensitivity guaiac or immunochemical FOBT (iFOBT/FIT): every 1-2 years (Consensus-based)
 * Colonoscopy: every 10 years (Consensus-based)
 * Combined FOBT and flexible sigmoidoscopy: every 1-2 years for FOBT, at least every 10 years for flexible sigmoidoscopy (Consensus-based)
 * Standard guaiac FOBT: every 1-2 years (Consensus-based)
 * Air contrast barium enema:** every 5 years (Consensus-based)
 * Virtual colonoscopy:** every 10 years (Consensus-based)
 * Fecal DNA:** every 5 years (Consensus-based)


 * The GDT recognizes that these screening intervals differ from current HEDIS measures. Some regions may choose to offer screening at more frequent intervals.  HEDIS intervals are as follows: FOBT (annual), flexible sigmoidoscopy (every 5 years), air contrast barium enema (every 5 years), colonoscopy (every 10 years).


 * These modalities are not recommended for screening average-risk adults (see Recommendation #2 above).

Recommendation 4: Age to Begin and End Colorectal Cancer Screening

In the absence of sufficient evidence, the following ages at which to begin and end colorectal cancer screening in asymptomatic average-risk adults are recommended:

1. Initiation of screening is recommended at age 50. (Consensus-based) 2. Discontinuation of screening is generally recommended at age 75, provided that there is a history of routine screening. For those with no history of routine screening, discontinuation is recommended at age 80. The decision to discontinue screening should be based on physician judgment, patient preference, the increased risk of complications in older adults, and existing comorbidities. (Consensus-based)  —Preceding unsigned comment added by Ocdcntx (talk • contribs) 15:22, 15 February 2010 (UTC)

Quotes from the hyperplastic section
They have no malignant potential, which means that they are no more likely than normal tissue to eventually become a cancer.

and then ...

Although thought to exhibit no malignant potential it has been shown that hyperplastic polyps on the right side of the colon do exhibit a malignant potential.

The section (and in the second one, even the sentence itself) seems to be contradicting itself. Which is it? Is there malignant potential or not? 76.169.117.255 (talk) 03:53, 25 October 2012 (UTC)

Large polyps
... can be resected endoscopically as long as there's surveillance - 10.1136/gutjnl-2014-308481 JFW &#124; T@lk  12:05, 8 April 2016 (UTC)

Statistics
I cannot find in the article what is the majority of colon polyps? Some sources say "Hyperplastic polyps account for the majority of colon polyps." https://www.oncolink.org/cancers/gastrointestinal/colon-cancer/risk-prevention-and-screening/all-about-colon-polyps

Some others Two-thirds of colon polyps are adenomas. https://www.uptodate.com/contents/colon-polyps-beyond-the-basics

Which is the correct information to add? thanks--2604:2000:718F:4700:E80D:D13E:2532:CE3E (talk) 22:34, 9 June 2017 (UTC)

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What is the source for the incidence pie chart?
Struggling to find if this data is legitimate, especially since the incidence rates are hard to find in the literature. 2601:197:800:905:E9DC:F480:7832:EACB (talk) 04:35, 1 June 2024 (UTC)