Predictors of advanced proximal neoplasia in persons with abnormal screening flexible sigmoidoscopy

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作者：

PF Pinsky，RE Schoen，JL Weissfeld，RS Bresalier，RB Hayes，JK Gohagan

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摘要：

Background & Aims: The relationship between distal and proximal colonic findings is uncertain. Thus, there is no consensus on which findings on screening flexible sigmoidoscopy should trigger colonoscopy. Methods: We analyzed data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial to assess the relationship between distal and proximal colonic findings. Results: A total of 8802 subjects had an abnormal baseline sigmoidoscopy and colonoscopy follow-up. Subjects with Conclusions: Among subjects with a polypoid lesion on screening flexible sigmoidoscopy, those with small tubular distal adenomas are at similar risk for advanced proximal neoplasia as those without distal adenomas. Subjects with a large, villous, or dysplastic distal adenoma are at increased risk. A strategy that encourages individuals with small tubular adenomas on sigmoidoscopy to undergo follow-up colonoscopy and excludes those with nonadenomatous lesions is of questionable validity, because both groups are at similar risk for advanced proximal neoplasia.

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关键词：

CI confidence interval FS flexible sigmoidoscopy OR odds ratio PLCO Prostate Lung Colorectal