|Do patients with rectosigmoid adenomas 5 mm or less in diameter need total colonoscopy?|
|PMID: 10462649 Owner: NLM Status: MEDLINE|
|BACKGROUND: The need for colonoscopy in the care of patients with rectosigmoid adenoma 5 mm or less in diameter is still debatable. METHODS: We estimated the prevalence of proximal adenomas among 3052 consecutive subjects undergoing total colonoscopy. Rectosigmoid adenoma was classified as diminutive (5 mm), small (6 to 10 mm), or large (>/=11 mm). Advanced proximal adenoma was 10 mm in diameter or larger, or with a villous component, severe dysplasia, or infiltrating adenocarcinoma. RESULTS: Proximal adenoma was found in 212 of 2483 patients (8.5%, 95% CI [7.5, 9.7]) without distal neoplastic polyps, 49 of 214 (22.9%, 95% CI [17.6, 29.2]) with diminutive, 44 of 174 (25.3%, 95% CI [19.1, 32.5] with small, and 70 of 181 (38.7%, 95% CI [31.6, 46.2]) with large distal adenoma. Advanced proximal adenoma was found in 49 (2.0%, 95% CI [1.5, 2.6]), 8 (3.7%, 95% CI [1.7, 7.5]), 17 (9.8%, 95% CI [6.0, 15.4]), and 29 patients (16.0%, 95% [11.2, 22.4]), respectively. In patients with distal adenoma risk for proximal lesions increased with increasing age, size, and number of distal adenomas (p = 0.01). Size of distal adenoma was the strongest predictor of the presence of proximal advanced adenoma (multivariate analyses). CONCLUSIONS: In a clinical setting, the decision to perform colonoscopy should take into account proximal lesions of clinical interest, life expectancy, costs, and risks associated with the procedure. When detection of advanced proximal adenoma is the goal, presence of distal diminutive adenoma alone might not be an indication for total colonoscopy.|
|S Sciallero; L Bonelli; H Aste; T Casetti; E Bertinelli; S Bartolini; R Parri; G Castiglione; P Mantellini; M Costantini; C Naldoni; P Bruzzi|
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|Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't|
|Title: Gastrointestinal endoscopy Volume: 50 ISSN: 0016-5107 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 1999 Sep|
|Created Date: 1999-10-07 Completed Date: 1999-10-07 Revised Date: 2006-11-15|
Medline Journal Info:
|Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: UNITED STATES|
|Languages: eng Pagination: 314-21 Citation Subset: IM|
|Unit of Cinical Epidemiology and Trials, National Institute for Cancer Research, Genoa, Italy.|
|APA/MLA Format Download EndNote Download BibTex|
Colonoscopy / methods, statistics & numerical data*
Colorectal Neoplasms / diagnosis, epidemiology, pathology*
Referral and Consultation / statistics & numerical data
Severity of Illness Index
Sigmoid Neoplasms / diagnosis, epidemiology, pathology
Sigmoidoscopy / methods, statistics & numerical data
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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