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Colorectal Polyps in the Elderly

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Abstract

Colorectal cancer is an important cause of morbidity and mortality among Western nations, and is more common in the elderly than in younger individuals. With the general acceptance of the adenoma-carcinoma sequence, the current consideration is that colorectal cancer is preventable if all adenomas are removed before they have the chance to progress to cancer. To that end, physicians should now advocate screening for colorectal cancer and through this effort a large number of patients with adenomatous polyps will be discovered. It is important to understand the strategy in dealing with this growing population of patients with adenomas. After an initial polypectomy, patients with adenomas should be entered into a surveillance program to detect and remove recurrent adenomas. Recommended surveillance intervals are shorter for patients with a family history of colorectal cancer, those with multiple adenomas (>2), large adenomas (≥1cm), or those whose adenomas have high-grade dysplasia, villous architecture, or that are cancerous. Effective chemoprevention would be a potential method of lengthening colonoscopic surveillance intervals. Unfortunately, no treatment has been found to be effective enough to alter our current surveillance practice. The only recommendation that can be made at this time for those patients with a history of colonic adenomas is to add 3 g/day of calcium carbonate to their diet, though its effect on adenoma recurrence is modest.

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Acknowledgements

The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

The authors would like to thank the Hope Tang Goodwin Foundation for their generous support of the Hope Babette Tang research fellowship in gastroenterology at the Mount Sinai Hospital. Grant support: Dr Miller is the Dr Hope Babette Tang Research fellow in gastroenterology at Mount Sinai Hospital.

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  1. Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, New York, USA

    Kenneth Miller &  Jerome D. Waye

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Correspondence to Jerome D. Waye.

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Miller, K., Waye, J.D. Colorectal Polyps in the Elderly. Drugs Aging 19, 393–404 (2002). https://doi.org/10.2165/00002512-200219060-00001

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