In this month’s column, I highlight three topics that are highly relevant to endoscopy clinical practice: colon polyp sizing, Helicobacter pylori’s relationship with gastric cancer and large nonpedunculated polyps.
Although pathologists report the size of colon polyps resected during colonoscopy, the accuracy of such size reporting is questionable. In this study, investigators showed that due to factors such as piecemeal resection, only 60% of polyps sent to pathology can be measured, and of those that are measured, shrinkage of polyp size occurs in almost 25% of the specimens.
The majority of the results showing a reduction in gastric incidents after H. pylori incidence—a known risk factor for noncardia gastric adenocarcinoma (NCGA)—are from data collected outside the United States. In the second study, a large population-based study from the United States, investigators show a continued significant risk reduction eight years later in NCGA after H. pylori eradication.
Large nonpedunculated colonic polyps (LNPCPs) seen during colonoscopy are associated with synchronous lesions in up to 60% of patients. In the third study I highlight, investigators report the characteristics and morphology of such lesions and show that a higher rate of synchronous lesions is found in large nongranular nonpedunculated colonic polyps.