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Gastrointestinal (GI) diagnostic studies are pivotal in confirming, ruling out, diagnosing, or staging various diseases, including cancers. Following diagnosis, allocating time for discussions with the patient and providing informational resources is crucial. Diagnostic assessments of the GI tract often occur in outpatient settings like endoscopy suites or GI labs. Preparation for these tests may include dietary restrictions, fasting, liquid bowel preparations, laxatives, enemas, and the...
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Related Experiment Video

Updated: Feb 24, 2026

Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
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Distribution of colorectal polyps: Implications for screening.

Carlo Senore1, Cristina Bellisario1, Nereo Segnan1

  • 1AOU Città della Salute e della Scienza, SC Epidemiologia, screening, registro tumori - CPO, Turin, Italy.

Best Practice & Research. Clinical Gastroenterology
|August 27, 2017
PubMed
Summary

Colorectal adenomas are increasingly found in the proximal colon with age. This trend may be influenced by better diagnostic tools and an aging population, but not consistently observed for sessile serrated polyps.

Keywords:
ColonoscopyColorectal adenomasFITProximal colonScreeningSigmoidoscopy

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Area of Science:

  • Gastroenterology
  • Oncology
  • Public Health

Background:

  • Colorectal cancer (CRC) incidence shows a shift towards the proximal colon.
  • Adenomas are precursors to CRC, suggesting a potential proximal migration of adenomas.

Purpose of the Study:

  • To assess adenoma and sessile serrated polyp (SSP) prevalence and distribution across the colon.
  • To evaluate trends in lesion distribution and the diagnostic performance of screening tests for proximal vs. distal lesions.

Main Methods:

  • Systematic literature review (PubMed, Embase, Cochrane) adhering to PRISMA guidelines.
  • Analysis of adult human studies published between January 2000 and February 2017.

Main Results:

  • Evidence suggests an age-related increase in proximal adenomas.
  • Trends for proximal shift in adenomas were reported by some studies, but not consistently.
  • Diagnostic performance of screening tests varies by colonic segment and patient characteristics.

Conclusions:

  • The hypothesis of increasing proximal adenomas with age is supported.
  • A similar trend was not confirmed for sessile serrated polyps/adenomas (SSP/A) in individuals aged 50+.
  • The observed proximalization of colorectal adenomas may be attributed to improved diagnostics and population aging.