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Commentary
October 21, 2009

Differences in Colon Adenomas and Carcinomas Among Women and MenPotential Clinical Implications

Author Affiliations

Author Affiliations: Department of Internal Medicine, NorthShore University HealthSystems, Evanston, Illinois, and University of Chicago Pritzker School of Medicine, Chicago, Illinois.

JAMA. 2009;302(15):1696-1697. doi:10.1001/jama.2009.1499

Colorectal cancer remains the third leading cause of cancer deaths among women and men in the United States, underscoring the need for more effective preventive strategies for both sexes. Many promising approaches are based on the adenoma-carcinoma paradigm of colon carcinogenesis. The clinical corollary to this model is that the presence of adenomas represents a robust marker of colon carcinogenesis. This leads to 2 distinct applications for colorectal cancer prevention: target for intervention and risk marker. Indeed, removing adenomas through colonoscopy has been shown to decrease future colorectal cancer occurrence by 75% to 90%. From a screening perspective, the colonoscopic adenoma identification is used clinically to gauge long-term risk and dictate the frequency of future colorectal cancer screening.

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