Concepedia

Risk of Advanced Proximal Neoplasms in Asymptomatic Adults According to the Distal Colorectal Findings

Thomas F. Imperiale, David R. Wagner, Ching Y. Lin, Gregory N. Larkin, James D. Rogge, David F. Ransohoff

New England Journal of Medicine · 2000 · 1.1K citations · 25 references

Open access

TL;DR

The clinical significance of distal colorectal polyps remains uncertain. The study assessed the risk of advanced proximal neoplasia in individuals with distal hyperplastic or neoplastic polyps versus those without distal polyps. Data were collected from 1,994 asymptomatic adults aged 50 or older undergoing first‑time colonoscopy in an employer‑sponsored program, with polyp location and histology recorded and cecal intubation achieved in 97% of cases.

Abstract

The clinical significance of a distal colorectal polyp is uncertain. We determined the risk of advanced proximal neoplasia, defined as a polyp with villous features, a polyp with high-grade dysplasia, or cancer, among persons with distal hyperplastic or neoplastic polyps as compared with the risk among persons with no distal polyps. We analyzed data from 1994 consecutive asymptomatic adults (age, 50 years or older) who underwent colonoscopic screening for the first time between September 1995 and December 1998 as part of a program sponsored by an employer. The location and histologic features of all polyps were recorded. Colonoscopy to the level of the cecum was completed in 97.0 percent of the patients.