Literature DB >> 15484347

Predicting proximal advanced neoplasms at screening sigmoidoscopy.

Carlo Senore1, Nereo Segnan, Luigina Bonelli, Stefania Sciallero, Marco Pennazio, Donato Angioli, Cristiano Crosta, Stefano Gasperoni, Giuseppe Malfitana.   

Abstract

PURPOSE: This study was designed to assess the predictive value for advanced proximal neoplasms (cancer, adenoma > or = 10 mm, or villous component > 20 percent, or severe dysplasia) of the characteristics of distal polyps.
METHODS: The study was conducted among patients, aged 55 to 64 years, referred for colonoscopy in the Italian trial of sigmoidoscopy screening for colorectal cancer. Patients reporting a history of colorectal cancer, adenomas, inflammatory bowel disease, recent colorectal endoscopy, or two first-degree relatives with colorectal cancer were excluded. We compared the prevalence of advanced proximal neoplasia in patients with "low-risk" (1-2 tubular adenomas, < 10 mm, with low-grade dysplasia, or hyperplastic polyp) and in those with "high-risk" (size, > or = 10 mm, or > or = 3 adenomas, or villous component > 20 percent, or severe dysplasia) polyps in the distal colon.
RESULTS: Of 426 patients with polyps > 5 mm, 29 (6.9 percent) were detected with an advanced proximal neoplasm (including 4 colorectal cancers). The prevalence of proximal advanced neoplasia was 9.4 percent among patients with high-risk distal polyps and 2.5 percent among those with low-risk lesions (adjusted odds ratio, 3.19; 95 percent confidence interval, 1.06-9.59). Approximately 40 people with low-risk distal polyps 6 to 9 mm should undergo colonoscopy to detect one proximal advanced neoplasm; the corresponding number for patients with high-risk distal polyps is 10.
CONCLUSIONS: The 2.5 percent prevalence of proximal advanced neoplasms among people with low-risk 6-mm to 9-mm distal polyps is similar to the prevalence observed among people without distal polyps. Restricting colonoscopy referral to patients with high-risk distal polyps might represent a cost-effective strategy in a screening context.

Entities:  

Mesh:

Year:  2004        PMID: 15484347     DOI: 10.1007/s10350-004-0595-y

Source DB:  PubMed          Journal:  Dis Colon Rectum        ISSN: 0012-3706            Impact factor:   4.585


  5 in total

1.  Safe investigation of isolated change in bowel habit with a flexible sigmoidoscopy? A systematic review and meta-analysis.

Authors:  Pjj Herrod; H Boyd-Carson; B Doleman; Jem Blackwell; Ejo Hardy; F Harper; J N Lund
Journal:  Ann R Coll Surg Engl       Date:  2019-03-11       Impact factor: 1.891

2.  Changing epidemiology of colorectal cancer makes screening sigmoidoscopy less useful for identifying carriers of colorectal neoplasms.

Authors:  Paul Rozen; Irena Liphshitz; Micha Barchana
Journal:  Dig Dis Sci       Date:  2012-04-01       Impact factor: 3.199

3.  Gastric dysplasia may be an independent risk factor of an advanced colorectal neoplasm.

Authors:  Rack Cheon Bae; Seong Woo Jeon; Han Jin Cho; Min Kyu Jung; Young Oh Kweon; Sung Kook Kim
Journal:  World J Gastroenterol       Date:  2009-12-07       Impact factor: 5.742

4.  Anatomic distribution of cancers and colorectal adenomas according to age and sex and relationship between proximal and distal neoplasms in an i-FOBT-positive average-risk Italian screening cohort.

Authors:  F Parente; S Bargiggia; C Boemo; C Vailati; E Bonoldi; A Ardizzoia; A Ilardo; F Tortorella; S Gallus
Journal:  Int J Colorectal Dis       Date:  2013-08-24       Impact factor: 2.571

Review 5.  Primary and secondary prevention of colorectal cancer.

Authors:  Pedro J Tárraga López; Juan Solera Albero; José Antonio Rodríguez-Montes
Journal:  Clin Med Insights Gastroenterol       Date:  2014-07-14
  5 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.