Any Polyp Type Raises CRC Risk

A finding of any type of polyp in the colon increases the risk for colorectal cancer (CRC), according to new findings from a large Swedish study.

At 10 years, the cumulative colorectal cancer incidence was 1.6% among patients with hyperplastic polyps, 2.5% among those with sessile serrated polyps, 2.7% for tubular adenomas, 5.1% for tubulovillous adenomas, and 8.6% for villous adenomas, as compared with 2.1% for the control group.

However, a higher risk for colorectal-related death was only observed in patients with sessile serrated polyps, tubulovillous adenomas, or villous adenomas.

The study was published online March 16 in Lancet Gastroenterology & Hepatology.

Any Type of Polyp Increases the Risk for Colorectal Cancer

Boldface sections are mine.

I had my first virtual visit with my physician yesterday.  I mentioned that I was postponing my colonoscopy this year for pandemic reasons.  She said that’s fine, don’t worry about it.  I read this article today.  Now I know why I’m on a three year callback.

 

Does A Normal Cardiac Catheterization Mean Your Coronary Arteries Are Truly “Clean?” — The Skeptical Cardiologist

For far too long, many patients have undergone a cardiac test that carries grave risks with the misunderstanding that they are getting the definitive assessment of their coronary arteries. Chances are if you have visited an emergency room in the USA with chest pain and you weren’t clearly having an acute heart attack, you ended up…

via Does A Normal Cardiac Catheterization Mean Your Coronary Arteries Are Truly “Clean?” — The Skeptical Cardiologist

Thank you Dr. Pearson.

An Early Look At AliveCor’s Amazing KardiaMobile 6L: Accurate 6 Lead ECG On Your Smartphone — The Skeptical Cardiologist

The skeptical cardiologist has been evaluating a demo version of AliveCor’s new KardiaMobile 6L. I have been a huge advocate of Kardia’s single lead ECG and use it with great success in dozens of my afib patients. I’ve written about how this personal ECG monitoring empowers patients and providers and is a crucial component of…

via An Early Look At AliveCor’s Amazing KardiaMobile 6L: Accurate 6 Lead ECG On Your Smartphone — The Skeptical Cardiologist

Thanks Doctor for the ECG history lesson and for sharing your insights.

And congratulations on the Stanley Cup!

Coronary Artery Calcium Scan Embraced By New AHA/ACC Cholesterol Guidelines: Will Insurance Coverage Follow?

Thank you Dr. Pearson.

The Skeptical Cardiologist

The skeptical cardiologist has been utilizing coronary artery calcium (CAC) scans to help decide which patients are at high risk for heart attacks, and sudden cardiac death for the last decade. As I first described in 2014, (see here) those with higher than expected calcium scores warrant more aggressive treatment and those with lower scores less aggrressive treatment.

Although , as I have discussed previously, CAC is not the “mammography of the heart” it is incredibly helpful in sorting out personalized cardiovascular risk. We use standard risk factors like lipids, smoking, age, gender and diabetes to stratify individuals according to their 10 year risk of atherosclerotic cardiovascular disease (ASCVD) but many apparent low risk individuals (often due to inherited familial risk) drop dead from ASCVD and many apparent high risk individuals don’t need statin therapy.

Previously, major guidelines from organizations like the AHA and the ACC did not recommend…

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NCI Study: MRI of the Prostate Misses Cancers

About 16% of lesions were missed, and approximately 5% of clinically important prostate cancers (>5 mm, Gleason score > 3+3) were underestimated on MP MRI, according to Baris Turkbey, MD, of the Molecular Imaging Program at the National Cancer Institute in Bethesda, Maryland, and colleagues. Overall, prostate cancer size was underestimated by at least 30% in eight (8%) of 100 patients. Their study was published online October 20 in Radiology.

Source: NCI Study: MRI of the Prostate Misses Cancers

Jargon Muddies Radiology Reports

The study, for which Dr Gunn was lead author, was a survey of 59 radiologists and 100 primary care physicians at Massachusetts General Hospital (MGH), which he undertook during his training there (J Am Coll Radiol. 2013;10:122-127).

Both groups of doctors were asked to consider hypothetical radiology reports and interpret the statistical likelihood (0% to 25%, 26% to 50%, and so on) of the presence of metastatic disease based on the terms used in the report.

The modifying terms were “diagnostic for,” “represents,” “likely represents,” “probably,” “consistent with,” “compatible with,” “concerning for,” “suspicious for,” “may represent,” and “cannot exclude.”

Source: Jargon Muddies Radiology Reports, Including About Cancers

The article comments are priceless.  For example, Dr. Mark Walters writes:

This is a made up problem.  I have never had a clinician, in 30 years of Radiology practice, come to me and say they did not understand the meaning of ” consistent with” or “cannot exclude”.

Clear as mud.