Date: 05 Aug 2014

Does the “Polyp Paradox” Really Exist?

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“Whatever logic is good enough to tell me is worth writing down.” This verse is also known as the Carroll’s paradox, written by Lewis Carroll in 1895 for the philosophical journal Mind.

Although Basil I. Hirschowitz invented the flexible fiber-optic endoscope in 1957, an innovation that radically revolutionized the practice of gastroenterology, its value for preventing colorectal cancer was not supported until 2013, when, based on a large-scale, long-term study, total colonoscopy was reported to reduce the incidence of colorectal cancer [1]. Importantly, that study also highlighted the limited effectiveness of colonoscopy in reducing the incidence of proximal (i.e., right sided) colorectal cancer after endoscopic polypectomy. Recently, Corley and co-workers, in another massive study, evaluated the adenoma detection rate (ADR) in relation to the risk of colorectal cancer and death [2]. The ADR, which ranged from 7 to 53 %, was inversely associated with the risk of interval cancer, advanc