Colorectal Adenomas

Colon cancer begins with the malignant transformation of benign adenomas and polyps. When adenomas are large or multiple, the risk of subsequent cancer is highest. Screening techniques, although imperfect, can reduce the incidence of colorectal cancer. Since the last review of colorectal adenomas in the Journal, 1 a wealth of new data has emerged that is improving our understanding of their clinical significance. In the past 10 years, several large studies, performed predominantly in the United States, have evaluated persons at average risk for colorectal adenomas. The new evidence that these studies have provided regarding the biology of adenomas, their prevalence and incidence, the relevance of risk profiles, and controversies in screening and surveillance is germane to clinical decisions and identifies potential targets for the improved management of these important premalignant lesions. Adenomas and Sessile Serrated Polyps . . .