[Epidemiologic study of the morphogenetic relation between adenoma and cancer of the colon]

An analysis of autopsy data from three departments of pathology in three countries differing in the prevalence of large intestinal cancers has confirmed that these cancers are related morphogenetically to adenomatous polyps (adenomas). The highest percentage of persons with adenomas occurred in a region where the prevalence of large intestinal cancer was also the highest. The segmental distribution++ of large adenomas in the colon correlated with that of cancer, although the frequency of adenomas in the rectum was low and could not explain the high risk of cancer arising in this segment. This indicates that adenomas either are less important in the pathogenesis of rectal cancer or undergo malignant change less commonly than do those in other portions of the large intestine. The high rate of hyperplastic polyps in the rectum correlated with rectal cancer morbidity, and hence it is suggested that although such polyps are not neoplasms, they nevertheless may serve as an indicator of increased risk of rectal cancer development.