Evidence map›Paper›PMID 31125546›Full record

ArticleGastrointestinal endoscopy2019

Association of small versus diminutive adenomas and the risk for metachronous advanced adenomas: data from the New Hampshire Colonoscopy Registry.

Joseph C Anderson, Douglas K Rex, Christina Robinson, Lynn F Butterly

Open access · greenAbstract readComparative Study
In one paragraph

Article in Gastrointestinal endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 28 citations in OpenAlex.

  1. Predictors of metachronous advanced colorectal adenoma after polypectomy.Journal of the Chinese Medical Association : JCMA · 2025
    Article
  2. Article
  3. Article
  4. Review
  5. Review
  6. [Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revised Edition].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2022
    Review
  7. Observational
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Joseph C AndersonMedicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA; New Hampshire Colonoscopy Registry, Lebanon, New Hampshire, USA.
Douglas K RexIndiana University School of Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Indianapolis, Indiana, USA.
Christina RobinsonNew Hampshire Colonoscopy Registry, Lebanon, New Hampshire, USA.
Lynn F ButterlyMedicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA; New Hampshire Colonoscopy Registry, Lebanon, New Hampshire, USA.
Dartmouth College · USIndiana University School of Medicine

Funding

Variations in Colonoscopy Screening: A Population Based StudyR01CA131141 · NCI · DARTMOUTH COLLEGE · PI BUTTERLY, LYNN F · 2008 to 2012
$4.5M
NCI NIH HHS R01 CA131141
6 · The paper itself

Abstract

BACKGROUND AND

aimsLimited data are available to investigate the impact of index adenoma size on the risk of metachronous advanced adenomas. Our goal was to examine the impact of having small (5-9 mm) versus diminutive (<5 mm) adenomas on the future risk of advanced adenomas within the categories for polyps <1 cm currently used in the United States: 1 to 2 and 3 or more tubular adenomas.

methodsWe included data from individuals participating in the statewide, population-based New Hampshire Colonoscopy Registry (NHCR). Groups were based on index findings: (1) 1 to 2 adenomas <5 mm (both diminutive), (2) 1 to 2 adenomas <1 cm (one or both small), (3) 3 to 10 adenomas <5 mm (all diminutive), (4) 3 to 10 adenomas <1 cm (one or more small), and (5) advanced adenomas (AA). AAs were defined as adenomas ≥1cm or those with villous elements or high-grade dysplasia or colorectal cancer (CRC). Outcomes were the absolute and adjusted risk of metachronous AAs. Covariates included age, sex, body mass index, family history of CRC, lifestyle factors, presence of serrated polyps, and time since the index examination.

resultsAfter adjusting for the covariates, we observed that having 1 to 2 adenomas with at least one 5 to 9 mm adenoma (adjusted odds ratio [AOR], 1.54; 95% confidence interval [CI], 1.12-2.11), 3 to 10 diminutive adenomas (AOR, 1.75; 95% CI, 1.03-2.95), 3 to 10 adenomas <1 cm (1 or more small) (AOR, 2.14; 95% CI, 1.39-3.29) or AAs (AOR, 2.77; 95% CI, 2.05-3.74) were associated with an increased risk for metachronous AA compared with having 1 to 2 diminutive adenomas. A further stratification of group 2 showed that those with exactly 2 small adenomas had an absolute risk of future AA of 7.6% (11/144) (95% CI, 4.3%-13.2%), higher than the absolute risk in the 1 to 2 diminutive polyp group, and similar to the risk for 3 to 10 adenomas of 8.2% (95% CI, 5.4-11.9).

conclusionsFor individuals with 1 to 2 adenomas <1 cm, having at least 1 small adenoma increased the metachronous risk of AA compared with having only diminutive adenomas. Furthermore, the subset with 2 small adenomas had a risk of future AA similar to the risk for 3 to 10 adenomas. These data suggest that individuals with at least 1 small adenoma may be at higher risk for future AAs and thus require closer follow-up than those with only diminutive adenomas. These data may be valuable to guideline committees for the creation of future surveillance recommendations.

Indexed as

AdenomaAdenomatous PolypsAgedColonic PolypsColonoscopyColorectal NeoplasmsEarly Detection of CancerFemaleHumansMaleMiddle AgedNeoplasms, Second PrimaryNew HampshireRegistriesTumor BurdenWatchful Waiting

Identifiers

PMID31125546
PMCPMC6707852
OpenAlexW2945726912

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.