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In the VA study they found about
a third of the people have an adenoma. Now these are almost exclusively men and men are
more likely to have adenomas than women. The key issue here is this advanced adenoma and
you should note that the definition of an advanced adenoma is somewhat ambiguous. The
notion is that there are some adenomas that have some histologic characteristics that
suggest that one is more likely to go on to cancer than a lot of the others. In this
study, they said about 10% met this definition. In this case it was a size definition.
Villous, which is the histology; high-grade dysplasia, which really is on the verge of
cancer; and actual cancer. That’s the distribution. When you look at it a little more
critically, maybe it’s only 5%, or maybe it’s only 2% or 3% that really are at an
advanced stage headed to cancer. |