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The National Polyp Study investigators recently reported a 53% reduction in colorectal-cancer mortality in their adenoma-bearing cohort despite a 57% prevalence of advanced adenomas at baseline examination (NEJM JW Gastroenterol Mar 2 2012).
The current study is a much larger evaluation of mortality in 40,826 Norwegian patients after adenoma removal. During a median of 7.7 years of follow-up, 1273 patients received a diagnosis of colorectal cancer and 383 died compared with 398 expected. Patients with high-risk adenomas (count ≥1 or having villous elements or high-grade dysplasia) had an increased risk for colorectal-cancer death (242 observed vs. 209 expected; standardized mortality ratio, 1.16). Patients with low-risk adenomas (1 adenoma) …