Subjects older than 60 years with negative findings on sigmoidoscopy should still undergo colonoscopy.
OBJECTIVE
The objective of this study was to evaluate the impact of age on the prevalence of proximal clinically important lesions in subjects without any rectosigmoid neoplasm.


METHODS
The present study involved 497 patients (aged > or = 50 years old) who underwent a colonoscopy because of abdominal symptoms or positive fecal occult blood test. A proximal colon was defined as one proximal to a sigmoid colon. Clinically important lesions were defined as adenocarcinoma, tubular adenoma > or = 1 cm in diameter, or adenoma with villous histology or high-grade dysplasia.


RESULTS
Of the 497 patients, 83 had clinically important lesions in the proximal colon. Of those 83, 53 patients had no neoplasm in the distal colon or rectum. In patients with no distal neoplasm, the prevalence of proximal clinically important lesions in subjects over 60 years old significantly exceeded that in patients aged 50-60 (39/105 vs. 14/125; P < 0.0001). In patients with distal neoplasm, the prevalence of proximal clinically important lesions in subjects over 60 was similar to that in 50 to 60-year-old subjects (16/119 vs. 14/148; P = 0.406).


CONCLUSIONS
Results suggest that subjects older than 60 years old should still undergo a colonoscopy even if they have no neoplasm on sigmoidoscopy.
Yoshinaga
Masahiro
M
Faculty of Medicine, Kyushu University, Fukuoka, Japan, Department of Internal Medicine, Fukuoka Teishin Hospital, 2-6-11 Yakuin, Fukuoka 810-8798, Japan. myoshi007@aol.com
Watabe
Rie
R
Takeda
Hiroko
H
Yanagisawa
Jiroo
J
Higuchi
Kazumi
K
Tsuda
Ysuo
Y
Harada
Naohiko
N
Nawata
Hajime
H
Ikeda
Keiichi
K
D000236:Adenoma / Q000175:diagnosis*; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D012812:Sigmoidoscopy