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Small polyps found during fiberoptic sigmoidoscopy in asymptomatic patients
Small rectosigmoid polyps found during screening sigmoidoscopy indicate a high risk for proximal neoplastic polyps. Colonoscopy is recommended for all patients with small polyps detected during sigmoidoscopy.
Area of Science:
- Gastroenterology
- Colorectal Cancer Screening
- Endoscopy
Background:
- Screening fiberoptic sigmoidoscopy is used to detect colorectal polyps.
- Small polyps in the rectosigmoid are common in asymptomatic individuals.
Purpose of the Study:
- To determine the prevalence of small rectosigmoid polyps in asymptomatic patients.
- To assess the likelihood of synchronous neoplastic polyps proximally during colonoscopy.
Main Methods:
- Asymptomatic patients with polyps ≤9 mm on sigmoidoscopy underwent colonoscopy.
- Polyps were removed, and histology was analyzed.
- Patients were categorized based on polyp histology.
Main Results:
- Of 3923 sigmoidoscopies, 7% revealed polyps ≤9 mm.
- Colonoscopy in 189 patients showed proximal neoplastic polyps in 29% of those with only hyperplastic polyps and 33% with neoplastic polyps.
- Results were consistent for polyps ≤5 mm.
Conclusions:
- Small rectosigmoid polyps, regardless of histology, signify a high risk for proximal neoplastic polyps.
- Current guidelines may require revision.
- Colonoscopy is indicated for all patients with small polyps found during sigmoidoscopy.
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