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Related Experiment Videos

Are tiny polyps important when found on sigmoidoscopy in asymptomatic people?

A Pines1, L Bat, J Rosenbaum

  • 1Gastroenterology Institute, Sheba Medical Center, Tel-Hashomer, Israel.

Journal of Clinical Gastroenterology
|September 1, 1992
PubMed
Summary

Asymptomatic patients with only small distal polyps found during flexible sigmoidoscopy had a 16% chance of developing proximal polyps. Further colonoscopy may be needed to detect these synchronous lesions.

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Area of Science:

  • Gastroenterology
  • Colorectal Cancer Screening
  • Endoscopy

Background:

  • Flexible sigmoidoscopy is a common screening tool for colorectal cancer.
  • Diminutive polyps are frequently found during these procedures.
  • The significance of diminutive polyps as predictors of proximal neoplasia is not fully understood.

Purpose of the Study:

  • To investigate the incidence of synchronous large bowel polyps proximal to the sigmoid in patients with diminutive distal polyps.
  • To evaluate the diagnostic yield of colonoscopy in this patient population.

Main Methods:

  • A prospective study involving 101 asymptomatic patients who underwent screening flexible sigmoidoscopy.
  • Patients with diminutive polyps (≤0.5 cm) as the sole distal finding proceeded to colonoscopy.

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  • Histopathological analysis of all polyps was performed.

    • Main Results:

    • 16% of patients had 21 additional proximal polyps detected by colonoscopy.
    • Most proximal polyps were small (<1 cm) and neoplastic (18/21).
    • No association was found between index polyp characteristics and the presence of proximal lesions.

    Conclusions:

    • A significant proportion of asymptomatic individuals with diminutive distal polyps harbor synchronous proximal polyps.
    • The findings question the routine justification of immediate colonoscopy for all patients with only diminutive polyps at flexible sigmoidoscopy.
    • Further research is needed to refine screening strategies.