Digestive Diseases and Sciences

, Volume 40, Issue 12, pp 2526–2531 | Cite as

Establishment of a colonic polyp registry in Rhode Island

  • Robert Lev
  • Robin Davies
  • Marius Lee
Gastrointestinal Oncology


A colonic adenomatous polyp registry (PR) has been organized at the Roger Williams Medical Center whose main functions are to prevent the occurrence of colorectal cancer (CRC) in the enrollees, to provide a population of subjects for epidemiological and interventional studies, and to provide educational, including dietary, information to subjects and physicians. One hundred fou and 202 patients with polyps, originally retrieved from the hospital pathology files, were enrolled in the 1984 and 1987 cohorts, respectively, of whom about 90% were followed for at least three years after polypectomy. Three carcinomas, all Dukes A, were found in the right colonin the follow-up period. New polyps identified in the first three years after polypectomy were generally small tubular adenomas with a greater predilection for the right colon than was found for the index polyps. Risk factors for new polyps included history of previous polyps and, probably, multiple index polyps. The use of colonoscopy for postopolypectomy surveillance increased between 1984 and 1987. About 25% of the subjects in, each cohort were either lost to follow-up or received no endoscopic suveillance. On the other hand, some of those who were followed were probably subjected to excessive numbers of procedures. Defects in the PR include inadequacy of personal and family history data, and steady loss of patients during the three to six years after polypectomy. Despite the small size and limited resources of our hospital, its colonic polyp registry has already provided information that may help in the management of patients with this premalignant condition. The more widespread use of securely funded polyp registries would probably reduce the incidence of metachronous CRC in that population and would have significant epidemiological and educational functions.

Key Words

colorectal cancer prevention colonoscopy surveillance risk factors epidemiology adenomatous polyp 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lev R: On controlling colorectal cancer. Hum Pathol 20:621–623, 1979Google Scholar
  2. 2.
    Hermanek P: Diagnosis and therapy of cancerous adenoma of the large bowel: A German experience.In: Adenomas and Adernomas Containing Carcinoma of the Large Bowel: Advances in Diagnosis and Therapy. CM Fenoglio-Preiser, FP Rossini (eds). New York: Raven Press, 1985, pp 57–62Google Scholar
  3. 3.
    Levi F, Randimbison L, LaVecchia C: Trends in subsite distribution of colorectal cancers and polyps from the Vaud Cancer Registry. Cancer 72:46–50, 1993Google Scholar
  4. 4.
    Suh O, Mettlin C, Petrelli N: Aspirin use, cancer and polyps of the large bowel. Cancer 72:1171–1177, 1993Google Scholar
  5. 5.
    Konishi F, Morson B: Pathology of colorectal adenomas: A colonoscopic survey. J Clin Pathol 35:830–841, 1982Google Scholar
  6. 6.
    Lev R: Defects in the current histological classification of adenomatous polyps of the colon. Surg Pathol 5:199–210, 1994Google Scholar
  7. 7.
    Winawer SJ, Zauber AG, Ho MN, O'Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF, Ackroyd F, Shike M, Kurtz RC, Hornsby-Lewis L, Gerdes H, Stewart ET, National Polyp Study Group: Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med 329:1977–1981, 1993Google Scholar
  8. 8.
    Greenberg ER, Baron JA, Tosteson TD, Freeman DH, Beck GJ, Bond JH, Colacchio TA, Coller JA, Frankl HD, Haile RW, Mandel JS, Nierenberg DW, Rothestein R, Snover DC, Stevens MM, Summers RW, Van Stolk RM: A clinical trial of antioxidant vitamins to prevent colorectal adenoma. N Engl J Med 331:141–147, 1994.Google Scholar
  9. 9.
    Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Speizer FE: Relation of meat, fat and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med 323:1664–1672, 1990Google Scholar
  10. 10.
    Lotfi AM, Spencer RJ, Ilstrup DM, Melton LJ: Colorectal polyps and the risk of subsequent carcinoma. Mayo Clin Proc 61:337–343, 1986Google Scholar
  11. 11.
    Atkin WS, Morson BC, Cuzick J: Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med 326:658–662, 1992Google Scholar
  12. 12.
    Simons BD, Morrison AS, Lev R, Verhoek-Oftedahl W: relationship of polyps to cancer of the large intestine. J Natl Cancer Inst 84:962–966, 1992Google Scholar
  13. 13.
    Lev, R. Adenomatous polyps of the Colon: Pathobiological and Clinical Features. Springer-Verlag, New York, 1990.Google Scholar
  14. 14.
    Winawer SJ, Zauber AG, O'Brien MJ, Ho MN, Gottlieb L, Sternberg SS, Waye JD, Bond J, Schapiro M, Stewart ET, Parish J, Ackroyd F, Kurtz RC, Shike M, National Polyp Study Workgroup: Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. N Engl J Med 328:901–906, 1993Google Scholar
  15. 15.
    Bond JH: Polyp guideline: Diagnosis, treatment and surveillance for patients with nonfamilial colorectal polyps. Ann Intern Med 119:836–843, 1993Google Scholar

Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Robert Lev
    • 1
  • Robin Davies
    • 1
  • Marius Lee
    • 1
  1. 1.Department of PathologyBrown University/Roger Williams Medical CenterProvidence

Personalised recommendations