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Incidence of rectosigmoid adenomatous polyps in subjects without prior colorectal adenoma or cancer: a prospective cohort study |
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| Authors: | Paillot B Czernichow P Michel P Merle V Queuniet A M Duval C Daubert H |
| Affiliation: | Service de Gastro-entérologie et Nutrition, Centre Regional de Lutte Contre le Cancer, Rouen, France. |
| Abstract: | BACKGROUND—Subjects without knowncolorectal adenomas or cancer constitute a large majority of thepopulation where 85% of all cases of colorectal cancer are thought tooccur. Consequently these people should be considered for screening todecrease mortality from colorectal cancer in the general population. AIMS—To estimate the incidence rateof rectosigmoid adenomas in these subjects. METHODS—Subjects without adenomasor cancer at a previous examination which had visualised therectosigmoid underwent a fibre endoscopy every three years. Endoscopicdata and population characteristics were collected prospectively. RESULTS—A total of 450 subjectsfulfilled the selection criteria; 287 (64%) underwent at least twoexaminations, and 163had three or more. At the second examination,with a mean delay of 39 months, the incidence rate of rectosigmoïdadenomas was 1.50% per patient year. The rate was 1.75% per patientyear (95% CI 0.80-3.33) at the third endoscopy with an additionalmean delay of 38 months. The cumulative incidence rate at six years was7.3% (95% CI 4.3-10.3), representing a mean of 1.2% per patientyear. This rate increased with age and was higher for men than forwomen after age adjustment (p< 0.03). CONCLUSIONS—The incidence rates arevery low compared with those of patients with prior adenomas. Theseresults should be considered in establishing rectosigmoid adenomascreening strategies. |
| Keywords: | adenomatous polyps epidemiology incidence colonicpolyps rectal neoplasms sigmoid neoplasms |
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