Korean J Gastroenterol.  2013 Jul;62(1):42-48. 10.4166/kjg.2013.62.1.42.

The Incidence and Clinical Characteristics of Proximal Colonic Polyps When the Polyps Are Noted on Rectosigmoid Colon by Colonoscopy

• Joo SK
• Kim JW
• Lee KL
• Kim BG
• Jeong JB
• Lee JK
• Koh SJ
• Kim YH

• KMID: 1711278
• DOI: http://doi.org/10.4166/kjg.2013.62.1.42

Abstract

BACKGROUND/AIMS
Colorectal cancer is the third most common type of cancer and second leading cause of cancer death overall. Recently, there has been an emphasis on primary screening for colorectal cancer with colonoscopy. In this study, we aimed to address clinical characteristics and incidence of colonic polyps according to location.
METHODS
From January 2009 to December 2010, 6,417 total colonoscopic examinations were performed at Boramae Hospital in Seoul, Korea. We reviewed these patients retrospectively. The distal colon was defined as the rectosigmoid junction.
RESULTS
Overall, 1,972 patients (31.3%) had one of more colorectal polyps. Total of 4,445 patients were excluded from this study because of combined advanced colorectal cancer, inflammatory bowel disease, or familial adenomatous polyposis. Patients who had only proximal polyps were 633 (32.1%), 530 patients (26.9%) had both proximal and distal polyps, and 809 patients (41.0%) had polyps only in the rectosigmoid region. The prevalence of the proximal polyps in patients with rectosigmoid polyps was found to be significantly related to the male gender and elderly patients. However, the prevalence of the proximal colonic polyps was not related to the size and number of rectosigmoid polyps. In 530 patients with both rectosigmoid and proximal colonic polyps, the characteristics of proximal colonic polyps as size and number were similar to those of rectosigmoid polyps. Advanced proximal adenomas without distal polyps were found in 25 (29.4%) patients whom were associated with size and pathology.
CONCLUSIONS
We recommend total colonoscopic examination in all patients regardless of the size and number, especially in elderly males.

Keyword

Colonic polyps; Colonoscopy; Adenoma

MeSH Terms

Adenoma/epidemiology/pathology
Adenoma, Villous/epidemiology/pathology
Adult
Age Factors
Aged
Aged, 80 and over
Colonic Polyps/*pathology
Colonoscopy
Colorectal Neoplasms/*epidemiology/pathology
Female
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Sex Factors

Figure

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  Fig. 1. Number of polyps. Total of 982 patients (49.8%) had a single polyp, 454 patients (23.0%) patients had two polyps and 536 (27.2%) patients had more than two polyps.

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  Fig. 2. Location of polyps. Total of 994 polyps (22.7%) were found in the cecum and ascending colon, 1,086 polyps (24.9%) in the transverse colon, 638 polyps (14.6%) in the descending colon, and 1,650 polyps (37.8%) in the rectosigmoid colon. A-colon, ascending colon; T-colon, transverse.

Reference

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