Original Contribution
The American Journal of Gastroenterology (2004) 99, 2012–2018; doi:10.1111/j.1572-0241.2004.30021.x
Phenotypic Characteristics and Risk of Cancer Development in Hyperplastic Polyposis: Case Series and Literature Review
Angel Ferrández MD1, Wade Samowitz MD1, James A DiSario MD1 and Randall W Burt MD1
1Department of Prevention and Outreach, Huntsman Cancer Institute at the University of Utah; Department of Pathology, University of Utah Health Sciences Center; Department of Gastroenterology, University of Utah Health Sciences Center; and Department of Prevention and Outreach, Huntsman Cancer Institute at the University of Utah
Correspondence: Angel Ferrández, MD, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
Received 9 January 2003; Revised 0000; Accepted 18 June 2004.
Abstract
OBJECTIVES:
Hyperplastic polyposis (HP) is a poorly understood condition. The aim of this study is to describe the phenotype and the risk of cancer in HP.
METHODS:
Patients with HP, as defined by the WHO International Classification, were identified through the University of Utah and the Huntsman Cancer Institute databases. Family history was retrieved when possible.
RESULTS:
Fifteen patients were identified (10 M, 5 F) with a mean age at diagnosis of 52.6 
16.4 yr (18–71). Sixty-five colonoscopies were performed (2–11 per person). A median of 90 polyps (16–210) per person and 15 polyps (range, 0–100) per procedure were reported. The median follow-up was 33 months (3–133); no cancer occurred during this period. Polyps were more frequent in the distal than the proximal colon (74%vs 26%; p < 0.001). The median polyp size was 4 mm (1–40 mm). Fifty-one hyperplastic polyps >10 mm were identified in 10 patients (38 proximal, 13 distal; p= 0.089). Forty-eight adenomas were found in 11 patients and were uniformly distributed. Serrated adenomas (n = 3) were found in one patient. A unique patient had 20 large hyperplastic polyps, 24 adenomas, 3 serrated adenomas, and 118 hyperplastic polyps. None of the patients had a first-degree relative with colon cancer.
CONCLUSIONS:
In HP, hyperplastic polyps are more frequently distal colonic, and vary greatly in size and number. Most patients also develop adenomas that are distributed throughout the colon. No cancers developed within 3 yr of follow-up. Colonoscopic surveillance at intervals of 1–3 yr, depending upon the number and size of both adenomatous and hyperplastic polyps, appears prudent.
