4493 Prediction of proximal colonic adenomas in patients with distal colonic polyps found on sigmoidoscopy: a prospective controlled study.

Abstract

Background & Aim: The significance of distal adenomas as a predictor of proximal neoplasms has remained controversial. Most studies to address this issue did not include a control group. The aim of this study was to examine whether rectosigmoid polyps could be markers for proximal lesions considering their size, number and pathology. Methods: A total of 367 asymptomatic patients with distal colonic polyps (314 adenomatous; 53 hyperplastic) noted on sigmoidoscopy and 83 asymptomatic controls without distal colonic polyps were prospectively evaluated with total colonoscopy from Mar 1998 to Oct 1999. No one had risk factors of colorectal cancers or polyps and had undergone barium enema or colonoscopy within five years before inclusion. The mean age (± SD) of the patients and controls was 52.5 ± 10.1 and 51.0 ± 8.7 years, respectively. Advanced adenomas were defined as adenomas >10 mm in diameter or with histology of villous or high grade dysplasia, and diminutive adenomas as 5 mm or less in size. Results: A greater percentage of patients with distal adenomas had synchronous proximal adenomas compared with those with distal hyperplastic polyps and the control group (30.3% vs 17.0% and 15.7%, p