FOLLOW-UP OF PATIENTS WITH HYPERPLASTIC POLYPS OF THE LARGE-BOWEL

Background: Adenomatous colonic polyps are accepted as premalignant le sions. There is controversy regarding the significance of the hyperpla stic polyp. The aim of this study was to determine the incidence of fu rther polyps in patients with only hyperplastic polyps on a first colo noscopy in comparison with patients without polyps and with adenomatou s polyps. Methods: Ninety patients had only hyperplastic polyps (group I). These patients were paired according to age and sex with subjects having no polyps (group II) and with patients having adenomas (group III). Results: Fifty-six patients in group I had at least one follow-u p examination. New polyps were found in 46.4% in group I versus 15.5% in group II (p < 0.001) and 50% in group III (NS). In group I, 30.7% o f new polyps were hyperplastic and 69.3% were adenomas. In fact, 32.2% of group I patients developed further adenomas (mean 1.5 +/- 0.8 aden omas). These adenomas occurred 1 to 4 years after the first polypectom y (mean 2.4 +/- 0.8 years). Most of these adenomas were small and tubu lar, but 16.6% were villous or had severe dysplasia. Conclusion: Patie nts with hyperplastic polyps were 2.4 times more likely to have furthe r adenomas than were those without polyps.