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Risk factors associated with colorectal flat adenoma detection

Risk factors associated with colorectal flat adenoma detection

News image

Colorectal flat adenomas have been associated with a higher risk of colorectal malignancy.

Dr Nicolás-Pérez and colleagues described demographic characteristics and endoscopic findings in patients with colorectal flat adenomas.

The team reported that in total, 1934 consecutive patients undergoing colonoscopy were prospectively included.

Polyp shape was classified according to the Japanese classification.

The doctors reported that chromoendoscopy was applied whenever a flat lesion was suspected.

Indications for colonoscopy, demographic data, and characteristics of neoplastic lesions were recorded.

Patients in Group 1 included no adenomas, patients in Group 2 had only protruding adenomas, patients in Group 3 had protruding and flat adenomas, and those in Group 4 had only flat adenomas.

Approximately 1 in every 10 patients had flat adenomas.

Screening colonoscopy was associated with flat adenoma detection
European Journal of Gastroenterology & Hepatology

The doctors examined that among them, concomitant protruding adenomas were identified in approximately half of the cases.

In multivariate analysis, age older than 50 years, protruding adenomas, follow-up colonoscopy for polyps or cancer, screening colonoscopy, and specifically trained endoscopist were associated independently with flat adenoma detection.

Dr Nicolás-Pérez's team concludes,  "Flat adenomas have specific demographic factors that might help to improve detection."

"Particularly, age older than 50 years, colorectal neoplasia surveillance, and the presence of protruding adenomas should alert endoscopists to the possible presence of these lesions."

"Trained endoscopists may offer a greater chance of detecting these lesions."

Eur J Gastroenterol Hepatol 2013: 25(3): 302-308
28 February 2013

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