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In total, 1934 consecutive patients undergoing colonoscopy were prospectively included. Polyp shape was classified according to the Japanese classification. Dr Nicolás-Pérez examined that chromoendoscopy was applied whenever a flat lesion was suspected. Indications for colonoscopy, demographic data, and characteristics of neoplastic lesions were recorded. Group 1 included patients with no adenomas. Patients in Group 2 only had protruding adenomas. Those in Group 3 had protruding and flat adenomas, and those in Group 4 had only flat adenomas.
Approximately 1 in every 10 patient had flat adenomas.  | | Concomitant protruding adenomas were identified in about half of the cases | | European Journal of Gastroenterology & Hepatology |
The doctors reported 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 commented, "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."
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