Do Distal Colonic Polyps Predict Proximal Adenomas?

Son, Hee Jung; Kim, Jae J; Rhee, Poong Lyul; Koh, Kwang Cheol; Paik, Seung Woon; Rhee, Jong Chul; Choi, Kyoo Wan; Oh, Young Lyun

Abstract

BACKGROUND AND AIMS
There has been a lot of controversy regarding the significance of hyperplastic or diminutive polyps found during sigmoidoscopy, as markers for synchronous adenomatous polyps. Therefore, prospective colonoscopy was performed in subjects with distal polyps found using sigmoidoscopy to determine the association between synchronous polyps with distal polyps.
METHODS
A sigmoidoscopy was performed in 2,895 subjects out of 10,705 who visited Samsung Medical Center for a routine check up from Aug. 1994 to Nov. 1995. Distal polyps were found in 590 of 2,895 and colonoscopy was performed in 280 of 590.
RESULTS
Of 280 subjects, 73 (26.1%) subjects had synchronous polyps and 55 subjects (19.6%) had synchronous adenomatous polyps. 134 polyps were found during colonoscopy; adenomatous polyps were most common (70.1%): Hyperplastic polyps (18.7%) and inflammatory polyps (11.2%) were also found. A greater percentage of subjects with distal adenomatous polyps had synchronous adenomatous polyps compared with those with distal hyperplastic polyps (25.1% vs. 6.3%, p<0.05). A greater percentage of subjects with distal large polyps (>0.5 cm) had synchronous adenomatous polyps compared with those with distal diminutive polyps (<=0.5 cm) (50.0% vs. 16.1%, p<0.05).
CONCLUSIONS
Adenomatous polyps found during sigmoidoscopy justify colonoscopy for synchronous polyps. However, diminutive hyperplastic polyps are not significant indicators of risk for synchronous adenomatous polyps.