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  • Title: Clinical factors associated with non-polypoid colonic adenomas ≥6 mm: a prospective study in an asymptomatic population using a high-definition colonoscope.
    Author: Johnson ME, Feinn R, Anderson JC.
    Journal: Am J Gastroenterol; 2011 Nov; 106(11):2018-22. PubMed ID: 21971537.
    Abstract:
    OBJECTIVES: To examine the clinical factors associated with adenomas ≥6 mm presenting as non-polypoid polyps. METHODS: We conducted a prospective cross-sectional examination with a target population of consecutive asymptomatic patients presenting to a University endoscopy center for screening colonoscopy. Data, which included demographics, known colorectal cancer risk factors, and medications, were collected. One endoscopist using a high-definition wide-angle colonoscope performed all of the colonoscopies. Polyp morphology was classified according to the JRSC (Japanese Research Society for Cancer of Colon and Rectum) JRSC guidelines. RESULTS: A total of 600 patients were screened and 150 adenomas ≥6 mm were detected. Of these 150 adenomas, 70 adenomas had a non-polypoid morphology while 80 were polypoid. Adenomas were more likely to present as non-polypoid in women as compared with men (adjusted odds ratio (AOR)=2.49; 95% confidence interval (CI)=1.08-5.75, P=0.03). Location of the adenoma in the proximal colon (AOR=4.21; 95% CI=1.83-9.71, P=0.001) and smoking (AOR=2.54; 95% CI=1.01-6.38, P=0.048) were independent predictors of flat morphology. In addition, advanced adenomas were also more likely to be flat in women (AOR=7.99; 95% CI=1.32-48.39, P=0.02) and proximal location was an independent predictor of flat morphology. CONCLUSIONS: Adenomas ≥6 mm and advanced lesions were more likely to present as non-polypoid polyps in women when compared with men. Proximal location and smoking were also observed to be independent predictors of flat morphology.
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