From the Guidelines
Tubular adenoma is a common type of benign polyp found in the colon that has the potential to develop into colorectal cancer if left untreated, and the most recent guidelines recommend complete removal and follow-up surveillance colonoscopies based on the number, size, and histology of the polyps found, with a repeat colonoscopy in 5-10 years for a single tubular adenoma smaller than 1 cm with low-grade dysplasia 1.
Key Points
- Tubular adenomas are characterized by their tubular glandular structure when examined under a microscope.
- Complete removal of the polyp is recommended, typically through polypectomy during the procedure.
- Follow-up surveillance colonoscopies are necessary, with timing based on the number, size, and histology of the polyps found.
- The development of tubular adenomas is associated with genetic factors, age, diet high in red meat and processed foods, smoking, alcohol consumption, and obesity.
- Maintaining a diet rich in fiber, fruits, and vegetables, regular exercise, limiting alcohol, and avoiding tobacco can help reduce the risk of developing these polyps.
Surveillance Recommendations
- For a single tubular adenoma smaller than 1 cm with low-grade dysplasia, a repeat colonoscopy in 5-10 years is typically recommended.
- For larger adenomas, multiple adenomas, or those with high-grade dysplasia, more frequent surveillance (3-5 years) is advised.
- The risk of proximal advanced adenomas and cancer among patients with 1 or 2 small distal adenomas found on flexible sigmoidoscopy is less than 10% 1.
Risk Factors
- Genetic factors
- Age
- Diet high in red meat and processed foods
- Smoking
- Alcohol consumption
- Obesity
Prevention
- Maintaining a diet rich in fiber, fruits, and vegetables
- Regular exercise
- Limiting alcohol
- Avoiding tobacco The most recent guidelines from the British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines provide evidence-based recommendations for the management of tubular adenomas 1.
From the Research
Definition and Risk Factors
- Tubular adenoma is a type of polyp found in the colon and rectum, which can be a precursor to colorectal cancer 2, 3, 4, 5, 6
- The use of nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin has been associated with a reduced risk of adenomatous polyps, including tubular adenoma 2, 3, 4, 6
Prevention and Treatment
- Regular use of aspirin and NSAIDs has been shown to reduce the risk of developing adenomatous polyps, including tubular adenoma 2, 3, 4, 6
- The removal of adenomas during screening colonoscopies can help prevent the development of colorectal cancer, especially in individuals with advanced adenomas or multiple nonadvanced adenomas 5
Epidemiology and Screening
- The risk of colorectal cancer increases in individuals with high-risk adenomas, such as advanced adenomas or multiple nonadvanced adenomas 5
- Screening colonoscopies can help identify individuals with adenomas and reduce the risk of colorectal cancer 5
- The use of NSAIDs and aspirin may have a protective effect against the development of colorectal adenomas and cancer, especially in certain population subgroups 3