Adenomatous Polypi of Large Intestine

Chapman, Irving

doi:10.1097/00000658-196302000-00007

Cited by 132 publications

(66 citation statements)

References 2 publications

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“…14 20 This is compatible with our results. To achieve a high attendance rate for a flexible sigmoidoscopy screening examination, it is probably wise to limit bowel cleansing to a small enema, for example a 240 ml sorbitol enema, administered immediately before the examination.…”

Section: Discussionsupporting

confidence: 93%

“…Autopsy studies have reported that 32–50% of women and 40–62% of men in the age group 60–80 years have adenomas 1214 15 20 Colonoscopic studies on age groups comparable with this study population found adenomas in 26% of women16 and 25–45% of men 16-1924 The percentage of subjects with only proximal adenomas compares with previous endoscopic studies, which have shown that 13–70% of adenoma bearers have no distal adenoma 3…”

Section: Discussionsupporting

confidence: 74%

“…Most of our knowledge of adenoma distribution is based on autopsy studies12-15 and studies on subjects being examined because of symptoms or as part of a health care programme 16-19. Autopsy studies have shown that the distribution of adenomas changes from predominantly left sided (distal) to right sided (proximal) localisation with increasing age,13-15 20 indicating that sigmoidoscopy may not be an ideal screening modality for older age groups.…”

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confidence: 99%

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Flexible sigmoidoscopy or colonoscopy as a screening modality for colorectal adenomas in older age groups? Findings in a cohort of the normal population aged 63-72 years

Thiis‐Evensen

Hoff

Sauar

et al. 1999

Gut

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Background-Most cases of colorectal cancer originate from adenomas. Removing adenomas has been shown to reduce the incidence of colorectal cancer. The design of cost eVective endoscopic screening programmes requires a knowledge of the distribution of adenomas in diVerent age groups. Aim-To investigate the distribution of colorectal adenomas in older age groups in the normal population. Method-A total of 356 men and women selected randomly from the population register were oVered a colonoscopic screening examination to detect and remove polyps. Results-In all, 241(68%) subjects, mean age 67.4 years (range 62-73), attended. The caecum was intubated in 193 (80%), and in this group 32 (38%) women and 51 (47%) men had adenomas. One hundred and ten (54%) of the adenomas and 11 (39%) of the "high risk adenomas" (adenomas larger than 10 mm in diameter, adenomas containing villous components, and adenomas with severe dysplasia) were found proximal to the sigmoid colon. In 36 (43%) of the subjects with adenomas, the adenomas were only found proximal to the sigmoid colon. Twenty two (11%) subjects had more than two adenomas. Of 203 adenomas discovered, 189 (93%) were less than 10 mm in diameter. Conclusion-More than half of the adenomas were localised proximal to the sigmoid colon, and, in nearly half of the adenoma bearing subjects examined, the adenoma was proximal to the descending colon. This indicates that a sigmoidoscopic screening examination in this age group would miss a substantial number of adenomas, but this may be acceptable as the vast majority of proximal adenomas do not progress to clinical cancer within the life expectancy of this age group. (Gut 1999;45:834-839)

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 74%

mentioning

confidence: 99%

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Flexible sigmoidoscopy or colonoscopy as a screening modality for colorectal adenomas in older age groups? Findings in a cohort of the normal population aged 63-72 years

Thiis‐Evensen

Hoff

Sauar

et al. 1999

Gut

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“…Disproportionally more large and dysplastic polyps were found on the left. His torical data from autopsy studies in New York City [76] and Detroit [77] also have shown an equal total number of adenomas in the right and in the left colon in a population with a distinct left-sided predominance of large pol yps and cancers. The Japanese immigrants to Hawaii had only 15% of their colorectal ade nomas in the sigmoid, whereas 44% of colo rectal cancers were found in that segment [78].…”

Section: Descriptive Epidem Iologymentioning

confidence: 96%

Are Right- and Left-Sided Colon Neoplasms Distinct Tumors?

Distler

Holt²

1997

Dig Dis

116

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Cancer of left and right colon has a differing prevalence at varying ages, in high- and low-incidence nations, as well as in men and in women. There also is a difference in clinical presentation, in prognosis, and possibly in genetic and environmental epidemiology. This review proposes that cancers of proximal and distal colon are different tumors because of their embryologic origin, genetic changes, and biologic identity. These factors are important in understanding the ‘shift of tumors from more distal to more proximal sites in the colon’ and in evaluating potential suggestions for instituting advances in diagnosis and prevention.

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“…Chapman (1963) states that 51 % of adults are affected, and that the incidence increases with advancing years up to 88% in centenarians. Bargen(1963), examining colons at necropsy under a magnifying glass, found an incidence of 69%.…”

Section: Incidencementioning

confidence: 99%