Risk of Colorectal Cancer in Families of Patients with Adenomatous Polyps

To the Editor: Winawer et al. (Jan. 11 issue)¹ found that the siblings and parents of patients with adenomatous polyps are at increased risk for colorectal cancer. The article indicates that 35.6 percent of the polyps studied were larger than 1 cm and that 37 percent had villous architecture. Was the increased familial risk related to these advanced polyps, as compared with all adenomas? For example, what were the risks when the largest adenoma was 0.5 cm or less and when the most advanced histologic type was tubular? Recent studies have indicated that the presence of a nonadvanced tubular adenoma . . .