Tags

Type your tag names separated by a space and hit enter

Risk of proximal colorectal neoplasia among asymptomatic patients with distal hyperplastic polyps.
Am J Med 2005; 118(10):1113-9AJ

Abstract

PURPOSE

Many guidelines on colorectal cancer screening do not consider distal hyperplastic polyps to be a marker for proximal neoplasia. However, 11 of 17 published studies have shown an increased risk of proximal neoplasia in patients with distal hyperplastic polyps. Our goal is to assess the risk of proximal neoplasia in asymptomatic patients with distal hyperplastic polyps, compared to those with distal tubular adenomas or no distal polyps.

METHODS

We assessed proximal (cecum, ascending, transverse colon and splenic flexure) and distal polyps in patients undergoing screening colonoscopy, classifying them into 3 groups: distal hyperplastic polyps only; distal adenomas with or without hyperplastic polyps; no distal polyps. The prevalence of proximal neoplasia and advanced neoplasia (polyps > or =1 cm, villous adenomas, or cancer) was compared among these groups.

RESULTS

Of 2357 patients, 427 (18%) had neoplasia, including 103 (4%) with advanced neoplasia. Proximal neoplasia occurred in 175 (9%) of 1896 patients with no distal polyps, compared with 28 (12%) of 237 with distal hyperplastic polyps (P = 0.20) and 64 (29%) of 224 with distal adenomas (P <0.0001). Proximal advanced neoplasia occurred in 39 (2%) patients with no distal polyps, compared with 4 (2%) with distal hyperplastic polyps (P = 0.70) and 9 (4%) with distal adenomas (P = 0.13).

CONCLUSIONS

Patients with distal hyperplastic polyps, unlike those with distal adenomas, do not exhibit an increased risk for proximal neoplasia or proximal advanced neoplasia compared to those with no distal polyps. The discovery of hyperplastic polyps on screening sigmoidoscopy should not prompt colonoscopy.

Authors+Show Affiliations

Gastroenterology Section, Virginia Mason Medical Center, Seattle, Wash 98101, USA. otto.lin@vmmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16194642

Citation

Lin, Otto S., et al. "Risk of Proximal Colorectal Neoplasia Among Asymptomatic Patients With Distal Hyperplastic Polyps." The American Journal of Medicine, vol. 118, no. 10, 2005, pp. 1113-9.
Lin OS, Schembre DB, McCormick SE, et al. Risk of proximal colorectal neoplasia among asymptomatic patients with distal hyperplastic polyps. Am J Med. 2005;118(10):1113-9.
Lin, O. S., Schembre, D. B., McCormick, S. E., Gluck, M., Patterson, D. J., Jiranek, G. C., ... Kozarek, R. A. (2005). Risk of proximal colorectal neoplasia among asymptomatic patients with distal hyperplastic polyps. The American Journal of Medicine, 118(10), pp. 1113-9.
Lin OS, et al. Risk of Proximal Colorectal Neoplasia Among Asymptomatic Patients With Distal Hyperplastic Polyps. Am J Med. 2005;118(10):1113-9. PubMed PMID: 16194642.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of proximal colorectal neoplasia among asymptomatic patients with distal hyperplastic polyps. AU - Lin,Otto S, AU - Schembre,Drew B, AU - McCormick,Susan E, AU - Gluck,Michael, AU - Patterson,David J, AU - Jiranek,Geoffrey C, AU - Soon,Maw-Soan, AU - Kozarek,Richard A, PY - 2004/12/02/received PY - 2005/10/1/pubmed PY - 2005/12/13/medline PY - 2005/10/1/entrez SP - 1113 EP - 9 JF - The American journal of medicine JO - Am. J. Med. VL - 118 IS - 10 N2 - PURPOSE: Many guidelines on colorectal cancer screening do not consider distal hyperplastic polyps to be a marker for proximal neoplasia. However, 11 of 17 published studies have shown an increased risk of proximal neoplasia in patients with distal hyperplastic polyps. Our goal is to assess the risk of proximal neoplasia in asymptomatic patients with distal hyperplastic polyps, compared to those with distal tubular adenomas or no distal polyps. METHODS: We assessed proximal (cecum, ascending, transverse colon and splenic flexure) and distal polyps in patients undergoing screening colonoscopy, classifying them into 3 groups: distal hyperplastic polyps only; distal adenomas with or without hyperplastic polyps; no distal polyps. The prevalence of proximal neoplasia and advanced neoplasia (polyps > or =1 cm, villous adenomas, or cancer) was compared among these groups. RESULTS: Of 2357 patients, 427 (18%) had neoplasia, including 103 (4%) with advanced neoplasia. Proximal neoplasia occurred in 175 (9%) of 1896 patients with no distal polyps, compared with 28 (12%) of 237 with distal hyperplastic polyps (P = 0.20) and 64 (29%) of 224 with distal adenomas (P <0.0001). Proximal advanced neoplasia occurred in 39 (2%) patients with no distal polyps, compared with 4 (2%) with distal hyperplastic polyps (P = 0.70) and 9 (4%) with distal adenomas (P = 0.13). CONCLUSIONS: Patients with distal hyperplastic polyps, unlike those with distal adenomas, do not exhibit an increased risk for proximal neoplasia or proximal advanced neoplasia compared to those with no distal polyps. The discovery of hyperplastic polyps on screening sigmoidoscopy should not prompt colonoscopy. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/16194642/Risk_of_proximal_colorectal_neoplasia_among_asymptomatic_patients_with_distal_hyperplastic_polyps_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00173-7 DB - PRIME DP - Unbound Medicine ER -