Colorectal Endoscopy, Advanced Adenomas, and Sessile Serrated Polyps: Implications for Proximal Colon Cancer View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2012-08

AUTHORS

Andrea N Burnett-Hartman, Polly A Newcomb, Amanda I Phipps, Michael N Passarelli, William M Grady, Melissa P Upton, Lee-Ching Zhu, John D Potter

ABSTRACT

OBJECTIVES: Colonoscopy is associated with a decreased risk of colorectal cancer but may be more effective in reducing the risk of distal than proximal malignancies. To gain insight into the differences between proximal and distal colon endoscopic performance, we conducted a case-control study of advanced adenomas, the primary targets of colorectal endoscopy screening, and sessile serrated polyps (SSPs), newly recognized precursor lesions for a colorectal cancer subset that occurs most often in the proximal colon. METHODS: The Group Health-based study population included 213 advanced adenoma cases, 172 SSP cases, and 1,704 controls aged 50-79 years, who received an index colonoscopy from 1998-2007. All participants completed a structured questionnaire covering endoscopy history. Participants with polyps underwent a standard pathology review to confirm the diagnosis and reclassify a subset as advanced adenomas or SSPs. Logistic regression analyses were conducted to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between endoscopy and advanced adenomas and SSPs separately; site-specific analyses were completed. RESULTS: Previous endoscopy was inversely associated with advanced adenomas in both the rectum/distal colon (OR=0.38; 95% CI: 0.26-0.56) and proximal colon (OR=0.31; 95% CI: 0.19-0.52), but there was no statistically significant association between previous endoscopy and SSPs (OR=0.80; 95%CI: 0.56-1.13). CONCLUSIONS: Our results support the hypothesis that the effect of endoscopy differs between advanced adenomas and SSPs. This may have implications for proximal colon cancer prevention and be due to the failure of endoscopy to detect/remove SSPs, or the hypothesized rapid development of SSPs. More... »

PAGES

1213

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/ajg.2012.167

DOI

http://dx.doi.org/10.1038/ajg.2012.167

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1022980293

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22688851


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