[Cancer and polyps of the large intestine]

Incidence and mortality of the carcinoma of the large intestine increase also in the GDR. Carcinomas mostly develop in adenomas of the large intestine in the course of several years. Nowadays the adenoma-carcinoma-sequence is regarded as ascertained. The environmental influences are of decisive importance for the genesis of the colon carcinoma. Apart from this also genetic factors play a part. Villous adenomas more frequently show malignant structures than tubular adenomas. In large adenomas with a diameter of more than 20 mm more frequently invasive carcinomas (20-40%) are found than in small adenomas with a diameter of less than 10 mm (1%). From this is to be derived the demand of the removal of all adenomas of the large intestine with a diameter larger than 5 mm. The method of choice of the treatment is the polypectomy and the technique with the diathermy loop.