PMID- 17188959
OWN - NLM
STAT- MEDLINE
DCOM- 20070130
LR  - 20191210
IS  - 0016-5085 (Print)
IS  - 0016-5085 (Linking)
VI  - 131
IP  - 6
DP  - 2006 Dec
TI  - Yield of advanced adenoma and cancer based on polyp size detected at screening 
      flexible sigmoidoscopy.
PG  - 1683-9
AB  - BACKGROUND & AIMS: Observational screening of the colon with subsequent referral 
      for colonoscopy raises questions about the threshold of polyp size that 
      necessitates referral. To examine the yield at colonoscopy when a given size 
      lesion is observed, we assessed the yield of advanced adenoma and cancer at 
      colonoscopy based on the size of the abnormality detected at flexible 
      sigmoidoscopy (FSG). METHODS: We used data from the Prostate, Lung, Colorectal, 
      and Ovarian Cancer Screening Trial, a randomized, controlled, community-based 
      study of FSG. RESULTS: Subsequent colonoscopy was performed on 10,850 subjects 
      (60.4% male; mean age, 62.9 years) with a polyp visualized on screening FSG. For 
      women with a polyp 0.5-0.9 cm on FSG (n = 1426), the yield in the distal colon on 
      colonoscopy was 0.6% for cancer (number needed to screen [NNS] = 166) and 14.5% 
      for advanced adenoma (NNS = 7). In men (n = 2183), the yield was 0.7% (NNS = 142) 
      for cancer and 15.9% (NNS = 6) for advanced adenoma. Among persons with polyps 
      0.5-0.9 cm identified on FSG, 5.5% (198/3609) had distal advanced adenomas that 
      measured <1.0 cm but had villous histology or high-grade dysplasia, and 9.9% 
      (357/3609) had adenomas > or =1 cm. CONCLUSIONS: The yield for a distal advanced 
      adenomatous lesion when a polyp 0.5-0.9 cm is observed at FSG is substantial and 
      is due to the presence of advanced histology in polyps <1 cm and to detection of 
      polyps that measure > or =1.0 cm on colonoscopy. Establishing thresholds for 
      observation versus evaluation will require careful assessment of the overall 
      yield.
FAU - Schoen, Robert E
AU  - Schoen RE
AD  - Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvani 
      15213-2582, USA. rschoen@pitt.edu
FAU - Weissfeld, Joel L
AU  - Weissfeld JL
FAU - Pinsky, Paul F
AU  - Pinsky PF
FAU - Riley, Thomas
AU  - Riley T
LA  - eng
GR  - N01-CN2551/CN/NCI NIH HHS/United States
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20060814
PL  - United States
TA  - Gastroenterology
JT  - Gastroenterology
JID - 0374630
SB  - IM
CIN - Gastroenterology. 2006 Dec;131(6):2006-9. PMID: 17188963
MH  - Adenoma/*diagnosis/*pathology
MH  - Aged
MH  - Colonic Neoplasms/*diagnosis/*pathology
MH  - Colonic Polyps/*pathology
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Male
MH  - Mass Screening/methods
MH  - Middle Aged
MH  - Randomized Controlled Trials as Topic
MH  - Sigmoidoscopy/*methods
EDAT- 2006/12/26 09:00
MHDA- 2007/01/31 09:00
CRDT- 2006/12/26 09:00
PHST- 2005/10/05 00:00 [received]
PHST- 2006/07/26 00:00 [accepted]
PHST- 2006/12/26 09:00 [pubmed]
PHST- 2007/01/31 09:00 [medline]
PHST- 2006/12/26 09:00 [entrez]
AID - S0016-5085(06)01784-7 [pii]
AID - 10.1053/j.gastro.2006.08.025 [doi]
PST - ppublish
SO  - Gastroenterology. 2006 Dec;131(6):1683-9. doi: 10.1053/j.gastro.2006.08.025. Epub 
      2006 Aug 14.