Redéfinir la gestion des polypes dans la prévention du cancer du côlon

 

Daniel Alexander Patrick von Renteln

Centre hospitalier de l'Université de Montréal (CHUM)

 

Domaine : cancer

Programme chercheurs-boursiers -cliniciens - Junior 1

Concours 2016-2017

One in 14 people in Quebec develops colon cancer during their life. Doctors aim to prevent this kind of cancer by offering regular exams of the large intestine. The aim of these exams is to find and remove lesions (polyps) that are at risk of developing into cancer in the future. Very small polyps (up to 5mm)  are often found during colonoscopy. Removing such small lesions can result in complications such as bleeding or damage to the wall of the large intestine. An alternative method is to use radiology (CT colonoscopy) to examine the large bowel. Using CT colonoscopy small lesions are not removed and a control examination is done after 5 years. Doing a control after 5 years does not increase the risk for cancer and could decreases health care costs for society and patients.

The first study of this proposed research program investigates if patients are willing to participate in a study that leaves small lesions found during colonoscopy in place and only takes them out if they have grown bigger than 5mm at the control examination. Medium sized polyps (6-19mm) in the large intestine have a higher risk of transforming into a cancer before the next control examination. Therefore, they need to be completely removed when found. The lesions are often not completely removed because the electric energy used to cut them out burns the surrounding tissues, which makes it difficult to see if the polyp was completely removed. In recent years specialized instruments (called "cold snares") that can cut out these lesions without electric energy have been developed.

The second research study compares the new snares with the old snares to see if removing the lesions without electric energy results in less incomplete polypectomies, and also to compare the complications between the two techniques.