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Distal colonic hyperplastic polyps do not predict proximal adenomas in asymptomatic average-risk subjects
D K Rex1, J J Smith, T M Ulbright
1Department of Medicine, Indiana University Medical Center, Indianapolis.
Gastroenterology
|January 1, 1992
Summary
Distal colonic hyperplastic polyps do not indicate a higher risk for proximal colonic adenomas in average-risk individuals undergoing screening colonoscopy. These polyps are not reliable markers for detecting advanced adenomas further up the colon.
Area of Science:
- Gastroenterology
- Colorectal Cancer Screening
- Polyp Pathology
Background:
- Distal colonic hyperplastic polyps are common findings during colonoscopy.
- Their association with proximal colonic adenomas, particularly in average-risk populations, requires clarification for effective screening strategies.
Purpose of the Study:
- To investigate the significance of distal colonic hyperplastic polyps as potential markers for proximal colonic adenomas.
- To determine if hyperplastic polyps in the distal colon predict the presence of adenomas in the proximal colon in asymptomatic, average-risk individuals.
Main Methods:
- A colonoscopy screening study involving 482 asymptomatic, average-risk subjects aged 50-75 years.
- Subjects had negative fecal occult blood test results.
- Analysis compared the incidence of proximal colonic adenomas in individuals with and without distal colonic hyperplastic polyps.
Main Results:
- The incidence of proximal adenomas was 18% in subjects with distal hyperplastic polyps, similar to 15% in those without distal polyps.
- However, the incidence of proximal adenomas was significantly higher (38%) in subjects with no distal colonic adenomas compared to those with no distal polyps or only hyperplastic polyps.
- This indicates that distal hyperplastic polyps are not associated with an increased risk of proximal adenomas.
Conclusions:
- Distal colonic hyperplastic polyps are not significant markers for identifying proximal colonic adenomas in asymptomatic, average-risk individuals.
- Current screening protocols should not rely on the presence of distal hyperplastic polyps to predict proximal adenoma risk.
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