Routine duodenal papillary biopsy enhances detection of duodenal papillary adenoma in familial adenomatous polyposis patients: a prospective cohort study.

Crucially, 53.13% (17/32) occurred in endoscopically normal papillae, while 84.38% (27/32) of adenoma patients had prior negative endoscopic screenings.

Beyond Spigelman stage, significant correlations with papilla adenomas included combined gastric antral adenomas (R = 0.470, p = 0.037), use of transparent cap (R = 0.691, p = 0.003), and abnormal papillary appearance (R = 0.885, p < 0.001).