Colon polyps historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]


In 1895, the first sigmoidoscopy was developed to visualize the colon. Since then, it has been used to screen for colon polyps and colorectal cancer. In 1975, it was reported that adenomas are the precursors of colorectal cancer and hyperplastic polyps are non-neoplastic lesions. Since 1992, different pathways of polyp-cancer have been introduced, including molecular adenoma-carcinoma progression, mutator phenotype, serrated (neoplasia) pathway.

Historical Perspective

  • In 1895, the first rigid sigmoidoscope was developed at Hopkins by Kelly.[1]
  • In 1927, Lockhart-Mummery and Dukes recognized the precancerous changes in the rectum and colon and identified the staging system for colorectal cancer.[2]
  • In 1960, Hertz and Deddish reported using sigmoidoscopy to screen colorectal cancer with 90% survival rate followed for over 15 years.[1]
  • In 1967, Greegor used guaiac card test to detect early-stage colorectal cancer.[3]
  • In 1973, Wolff and Shinya used colonoscopy to remove polyps.[4]
  • In 1975, Morson was the first who reported that adenomas are the precursors of colorectal cancer and hyperplastic polyps are non-neoplastic lesions.[5]
  • In 1988, Vogelstein introduced molecular adenoma-carcinoma progression model which APC mutations are the initiator factors, known as a classic adenoma-carcinoma pathway.[6]
  • In 1992, another pathway known as the mutator phenotype was discovered in HNPCC patients.[7]
  • In 1993, the polyp-cancer sequence was accepted by the National Polyp Study.[8]
  • In 1999, Jass demonstrated another pathway related to serrated polyps, known as “serrated (neoplasia) pathway.”[7]

Landmark Events in the Development of Treatment Strategies


  1. 1.0 1.1 Winawer, Sidney J. (2015). "The History of Colorectal Cancer Screening: A Personal Perspective". Digestive Diseases and Sciences. 60 (3): 596–608. doi:10.1007/s10620-014-3466-y. ISSN 0163-2116.
  2. Bonnington, Stewart N (2016). "Surveillance of colonic polyps: Are we getting it right?". World Journal of Gastroenterology. 22 (6): 1925. doi:10.3748/wjg.v22.i6.1925. ISSN 1007-9327.
  3. Greegor, David H. (1967). "Diagnosis of Large-Bowel Cancer in the Asymptomatic Patient". JAMA: The Journal of the American Medical Association. 201 (12): 943. doi:10.1001/jama.1967.03130120051012. ISSN 0098-7484.
  4. 4.0 4.1 Wolff, William I.; Shinya, Hiromi (1973). "Polypectomy Via the Fiberoptic Colonoscope". New England Journal of Medicine. 288 (7): 329–332. doi:10.1056/NEJM197302152880701. ISSN 0028-4793.
  5. Muto T, Bussey HJ, Morson BC (1975). "The evolution of cancer of the colon and rectum". Cancer. 36 (6): 2251–70. PMID 1203876.
  6. O'Brien, Michael J. (2007). "Hyperplastic and Serrated Polyps of the Colorectum". Gastroenterology Clinics of North America. 36 (4): 947–968. doi:10.1016/j.gtc.2007.08.007. ISSN 0889-8553.
  7. 7.0 7.1 Rüschoff J, Aust D, Hartmann A (2007). "[Colorectal serrated adenoma: diagnostic criteria and clinical implications]". Verh Dtsch Ges Pathol (in German). 91: 119–25. PMID 18314605.
  8. Winawer, Sidney J.; Zauber, Ann G.; Ho, May Nah; O'Brien, Michael J.; Gottlieb, Leonard S.; Sternberg, Stephen S.; Waye, Jerome D.; Schapiro, Melvin; Bond, John H.; Panish, Joel F.; Ackroyd, Frederick; Shike, Moshe; Kurtz, Robert C.; Hornsby-Lewis, Lynn; Gerdes, Hans; Stewart, Edward T. (1993). "Prevention of Colorectal Cancer by Colonoscopic Polypectomy". New England Journal of Medicine. 329 (27): 1977–1981. doi:10.1056/NEJM199312303292701. ISSN 0028-4793.