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Gastroenterology  (Expert Forum)
 | 
Risk of Cancer
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

Risk of Cancer

by ammar, Oct 17, 2005 12:00AM
I underwent a standard endoscopy (including colonoscopy)and the following were the findings from it and the histopathy:

(1) mild erythema conssistent with Grade 1 gastro-oesophageal reflux disease;
(2) mild antral gastrities, clo test negative, rest of stomach and duodenum normal;
(3) two rectal polyps (both of them showing predominantly low grade dysplassia) representing a villous adenoma with low grade dysplasia and a tubulovillous adenoma with high grade dysplasia found focally in it. Rest of colon to caecum noted to be normal. The two polyps were completely snared and retrieved.

What is the risk and time frame of the possibility of my getting colorectal cancer and/or gastro-oesophageal cancer? What kind of lifestyle and food habits I should adopt to minimise the risk?

by Kevin Pho, MD, Oct 17, 2005 12:00AM
Of the polyps removed, the villous adenoma with high grade dysplasia is most at risk for developing into cancer - with up to 30 percent becoming cancerous.  

Appropriate followup would depend on the size of the polyp removed.  Since there were villous adenomas found, guidelines would recommend a repeat colonoscopy in 3 years.  

Regarding the upper endoscopy - there is no consensus as to how often to screen for Barrett's esophagus or esophageal cancer in chronic GERD patients.  

I would discuss these options with your gastroenterologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com
Member Comments (1)

by JackieG, Oct 17, 2005 12:00AM
Regarding the GERD/Barrett's screening, if you have made the appropriate lifestyle changes and annual endoscopies show the Barrett's to be stable after three to five years of surviellance, you can probably go to an endoscopy every five years.  However, if you notice any changes in your ability to swallow, you should schedule another andoscopy as soon as possible.

Good luck,
Chicken Soup
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