What is the consequence of hyperplastic polyps ? Do adenomas and colorectal cancer develop in these patients ? A clinical study

Aim : Do patients with hyperplastic polyps (HP) have an increased risk for developing adenomas and colorectal cancer (CRC) ? A study was done to detect the number of patients developing adenomas and CRC. Material and methods : From 1990-1995 all patients with a HP diagnosed via endoscopy and significant follow-up were studied. The patients were separated in three groups ; Group 1 HP in patients with previous adenoma and/or CRC. Group 2 HP with a concurrent adenoma and/or CRC. Group 3 patients with only HP. Results : Group 1 consisted of 20 patients, group 2 of 39 patients, and group 3 of 136 patients The follow-up was 12.5, 12.6, and 13.4 years respectively. In group 1 there was one patient with an adenoma in the index investigation. In group 2 adenomas were seen coinciding to hyperplastic polyp(s) in 29 patients, while in 11 cases there was a colorectal cancer. Obviously patients in group 3 only had hyperplastic polyps. In group 1 7 patients previously had an adenoma and 12 previously had colorectal cancer. Four patients in group 3 developed cancer : 13, 14, 15, and 15 years after the detec- tion of a hyperplastic polyp. In group 2 only one patient developed cancer in the cecum 9 years after the index investigation. In the four patients of group 3 who developed cancer no one previously had a serrated adenoma at revision of the original histology. Twelve patients developed an adenoma. Conclusion : Only five CRC's developed in patients with HP. Thus, at the best the risk for developing CRC in patients with HP is not very high and equals that of adenomas. (Acta gastroenterol. belg., 2010, 73, 441-444).