Prevalence of colonic neoplasia and advanced lesions in the normal population: a prospective population-based colonoscopy study.
OBJECTIVE
There are few prospective studies of the prevalence of colonic neoplasia in the normal population. In order to properly evaluate screening-protocols for colorectal cancer in risk groups (e.g., older subjects or those with a family history), it is essential to know the prevalence of adenomas and cancer in the normal population.


METHODS
A prospective population-based colonoscopy study on 745 individuals born in Sweden aged 19-70 years was conducted (mean age 51.1 years). All polyps seen were retrieved and examined.


RESULTS
Out of the 745 individuals 27% had polyps, regardless of kind. Adenomas were found in 10% of the individuals and finding of adenomas was positively correlated to higher age. Men had adenomas in 15% and women in 6% of the cases. Women had a right-sided dominance of adenomas. Hyperplastic polyps were seen in 21% of the individuals. The presence of hyperplastic polyps was significantly positively correlated to the presence of adenomas. Advanced adenomas were seen in 2.8% of the study participants, but no cancers were detected.


CONCLUSIONS
One in 10 healthy subjects had an adenoma but advanced adenomas were uncommon. Men and women have a different adenoma prevalence and localization. The results provide baseline European data for evaluating colonoscopy screening-protocols for colorectal cancer risk groups, and the findings may have implications for colon cancer screening in the normal, otherwise-healthy population.
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. anna.forsberg@ki.se
Anna M
AM
Forsberg
Lars
L
Kjellström
Lars
L
Agréus
Anna
A
Nixon Andreasson
Henry
H
Nyhlin
Nicholas J
NJ
Talley
Erik
E
Björck
D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000453:epidemiology*; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult