From the Guidelines
Sessile gastric polyps measuring 7-10 mm are generally not highly worrisome for gastric cancer, but they do warrant removal and histological examination. Most gastric polyps of this size are benign, with the majority being either hyperplastic polyps or fundic gland polyps. However, the risk of malignancy increases with polyp size, particularly when polyps exceed 10 mm. For polyps in the 7-10 mm range, endoscopic resection is typically recommended to obtain tissue for pathological examination and to definitively rule out malignancy, as suggested by the US Multi-Society Task Force on Colorectal Cancer 1.
Key Considerations
- The concern for malignancy also varies based on polyp type, with adenomatous polyps carrying higher cancer risk than hyperplastic or fundic gland polyps.
- Other factors that increase concern include rapid growth between examinations, irregular surface features, ulceration, or location in high-risk areas such as the lesser curvature or antrum of the stomach.
- Patients with multiple polyps or underlying conditions like atrophic gastritis or H. pylori infection may require more careful monitoring, as noted in studies on colorectal cancer risk factors 1.
Management Approach
- Endoscopic resection is the preferred method for removing sessile polyps, especially those that are 10 mm or larger, due to the increased risk of submucosal invasion with larger lesions 1.
- After removal, follow-up surveillance endoscopy is usually advised, with timing dependent on the histological findings, family history, and other risk factors.
- The British Society of Gastroenterology recommends a one-off colonoscopic surveillance examination at 3 years for patients with sessile serrated lesions that appear associated with a higher risk of future neoplasia or colorectal cancer, although this guideline may not directly apply to gastric polyps 1.
Conclusion Not Applicable - Direct Answer Only
Removal and histological examination of 7-10 mm sessile gastric polyps are crucial for early detection and management of potential malignancy, considering the low but present risk of gastric cancer in these lesions, as informed by the most recent and highest quality studies available 1.
From the Research
Gastric Cancer Risk and Sessile Polyps
- The risk of gastric cancer associated with 7-10 mm sessile polyps is not directly addressed in the provided studies.
- However, a study on the treatment of Helicobacter pylori infection 2 notes that H. pylori infection is a common cause of peptic ulcer disease and gastric cancer.
- Another study on the prevention of metachronous gastric cancer 3 found that H. pylori eradication therapy reduced the incidence of metachronous gastric cancer in patients who had undergone endoscopic resection of early gastric cancer.
Polyp Size and Cancer Risk
- A study on the indications for endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) for early gastric cancer 4 suggests that the risk of lymph node metastasis increases with the size and depth of the tumor.
- However, this study does not provide specific information on the risk of gastric cancer associated with 7-10 mm sessile polyps.
Endoscopic Resection of Sessile Polyps
- A systematic review and meta-analysis on the efficacy and safety of endoscopic resection of sessile serrated polyps 10 mm or larger 5 found that these polyps can be safely resected with low residual polyp rates.
- However, the study notes that polyp size ≥ 20 mm is a significant factor for residual polyp, and that cold endoscopic mucosal resection (EMR) may be associated with a lower rate of delayed bleeding compared to hot EMR.
Conclusion Not Applicable
As per the provided instructions, a conclusion section is not applicable in this response. The information provided is based on the available studies and is intended to inform the discussion on the risk of gastric cancer associated with 7-10 mm sessile polyps.