Open AccessIs there a proximal shift in the distribution of colorectal adenomas?
Author(s) -
de Oliveira Ana Maria Freire,
Anapaz Vera,
Lourenço Luís,
Graça Rodrigues Catarina,
Folgado Alberto Sara,
Martins Alexandra,
Ramos de Deus João,
Reis Jorge
Publication year - 2015
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640615577534
Subject(s) - medicine , colorectal cancer , gastroenterology , colonoscopy , incidence (geometry) , adenoma , dysplasia , adenomatous polyps , colorectal polyp , colorectal adenoma , cancer , physics , optics
Several studies have shown a proximal shift of colorectal cancer (CRC) during the last decades. However, few have analyzed the changing distribution of adenomas over time. Aim The aim of this study was to compare the site and the characteristics of colorectal adenomas, in a single center, during two periods. Methods We conducted a retrospective, observational study in a single hospital of adenomas removed during a total colonoscopy in two one‐year periods: 2003 (period 1) and 2012 (period 2). Patients with inflammatory bowel disease, familial adenomatous polyposis, hereditary non‐polyposis colorectal cancer syndrome, or history of CRC were excluded from the study. The χ 2 statistical test was performed. P values less than 0.05 were considered statistically significant. Results During the two considered periods, a total of 864 adenomas from 2394 complete colonoscopies were analyzed: 333 adenomas from 998 colonoscopies during period 1 and 531 adenomas from 1396 colonoscopies during period 2. There was a significant increase in the proportion of adenomatous polyps in the proximal colon from period 1 to 2 (30.6% to 38.8% ( p = 0.015)). Comparing the advanced features of adenomas between the two periods, it was noted that in period 2, the number of adenomas with size ≥1 cm ( p = 0.001), high‐grade dysplasia ( p = 0.001), and villous features ( p < 0.0001) had a significant increase compared to period 1. Conclusion Incidence of adenomatous polyps in the proximal colon as well as adenomas with advanced features has increased in the last years. This finding may have important implications regarding methods of CRC screening.