Author(s): Patel K, Hoffman NE
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Abstract BACKGROUND: Colorectal carcinoma is one of the most common causes of cancer-related deaths in Australia. The distribution of polyps in the colon may effect the efficacy of a screening modality. The aim of this study was to determine the age-matched anatomic location and histologic type of colorectal polyps observed at colonoscopy over a 10-year period at our endoscopy unit. STUDY: Endoscopy reports on 2,578 patients were reviewed; polyp/lesion histology and location (left, right, or both) were determined in 2,553. RESULTS: Of all polyps observed, 1,310 (51\%) cases were left-sided, 510 (20\%) were right-sided, and 733 (29\%) were synchronous. Adenomas were present in 1,659 cases (65\%); of these, 734 (44\%) were left-sided only and 405 (24.5\%) were right-sided only. Carcinoma was observed in 189 (7\%) cases, of which 71 (37.5\%) were left-sided only. There was an increased right-sided prevalence of adenoma or carcinoma with age (p = 0.0029). CONCLUSION: This was not a screening study, but it has shown that a significant number of adenomas and carcinomas lie proximal to the splenic flexure. Thus, in the absence of left-sided lesions, it is expected that examination of the colon limited to the splenic flexure would miss 23\% of such lesions. The increasing right-sided prevalence of these lesions with age suggests that evaluation of the proximal bowel is particularly important in older people.
This article was published in J Clin Gastroenterol
and referenced in Journal of Gastrointestinal & Digestive System