Likelihood of missed and recurrent adenomas in the proximal versus the distal colon.
Gastrointest Endosc
; 74(2): 253-61, 2011 Aug.
Article
em En
| MEDLINE
| ID: mdl-21549375
ABSTRACT
BACKGROUND:
Colonoscopy may be less efficacious in reducing colorectal cancer mortality in the proximal compared with the distal colon. A greater likelihood for missed and recurrent adenomas in the proximal colon may contribute to this phenomenon.OBJECTIVE:
To examine whether a proximal adenoma is associated with the risk and location of missed and recurrent adenomas.DESIGN:
Prospective.SETTING:
Polyp Prevention Trial.PARTICIPANTS:
A total of 1864 patients with an adenoma at baseline underwent a follow-up colonoscopy 4 years later (adenoma recurrence). Of these, 1731 underwent a clearing colonoscopy 1 year after the baseline examination (missed adenoma). MAIN OUTCOME MEASUREMENTS Association of baseline adenoma location with the risk and location of adenomas found at colonoscopy performed 1 year and 4 years later.RESULTS:
At the year 1 colonoscopy, 598 patients (34.6%) had an adenoma (missed adenoma). Compared with those with a distal-only adenoma at baseline, patients with a proximal-only adenoma at baseline were more likely to have any missed adenomas (relative risk [RR] 1.28; 95% CI, 1.09-1.49) and a proximal-only missed adenoma (RR 2.05; 95% CI, 1.49-2.80). At the year 4 colonoscopy, 733 patients (39.3%) had adenoma recurrence. Patients with a baseline proximal-only adenoma were more likely to have any adenoma recurrence (RR 1.14; 95% CI, 1.00-1.31) and a proximal-only adenoma recurrence (RR 1.52; 95% CI, 1.15-2.02). Sensitivity analyses involving missed adenomas did not materially affect the risk or location of recurrent adenomas at year 4 colonoscopy.LIMITATION:
Lesions may still be missed on repeated colonoscopies.CONCLUSIONS:
Missed and recurrent adenomas are more likely to be in the proximal colon.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Colo Sigmoide
/
Adenoma
/
Neoplasias do Colo
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Colo Ascendente
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Colo Descendente
/
Colo Transverso
/
Recidiva Local de Neoplasia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article