Abstract
Background Juvenile polyps, classified as hamartomatous lesions with neoplastic potential, are the most common gastrointestinal polyp of childhood. Risk factors for neoplasia include germline DNA mutations, a family history of juvenile polyps, and multiple polyps (≥3 or ≥5). Only a few large pediatric series (>100patients) of patients with juvenile polyps have been reported, with limited data about repeat surveillance colonoscopy and the incidence of neoplasia. The primary aim of this study was to identify a large cohort of children with one or more juvenile polyps for descriptive analysis of patient demographics, polyp number, location, repeat co1onoscopy, and neoplasia.
Highlights
Juvenile polyps, classified as hamartomatous lesions with neoplastic potential, are the most common gastrointestinal polyp of childhood
Germline DNA mutations were identified in 5 of 17(29.4%) patients tested including SMAD4 (n=2), BMPR1A (n=l), PTEN (n=2). 192 patients underwent complete colonoscopy at initial diagnosis, revealing 1 polyp in 117(60.9%)[Group A] and >1 polyp in 75(39.1%)[Group B]. 60(31.2%) patients had ≥3 polyps and 29(15.1 %) patients had ≥5 polyps. 128 (66.7%) patients had polyps limited to the left colon and
Group B was more likely than Group A to have a family history of a 1st or 2nd degree relative with polyps or colon cancer(p=0.006) but no significant difference was found between groups for gender, age, or race. 62 of 192 (32.3%) patients underwent repeat surveillance colonoscopy for polyp detection or removal
Summary
Juvenile polyps, classified as hamartomatous lesions with neoplastic potential, are the most common gastrointestinal polyp of childhood. Risk factors for neoplasia include germline DNA mutations, a family history of juvenile polyps, and multiple polyps (≥3 or ≥5). A few large pediatric series (>100patients) of patients with juvenile polyps have been reported, with limited data about repeat surveillance colonoscopy and the incidence of neoplasia. The primary aim of this study was to identify a large cohort of children with one or more juvenile polyps for descriptive analysis of patient demographics, polyp number, location, repeat co1onoscopy, and neoplasia
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