title: Patient age and duration of colonoscopy are predictors for adenoma detection in both proximal and distal colon.
abstract: OBJECTIVE
  To investigate the relation of patient characteristics and procedural parameters to the endoscopic detection rate of colonic adenomas. Further to study, which factors may be capable to predict the localization of adenomatous lesions.
  
  
  METHODS
  We used the data base of a prospective randomized colonoscopy study (The ColoCap trial) to identify patients being diagnosed with colon adenoma. Logistic regression analysis was conducted to reveal predictors for adenoma detection in the entire colon and also with respect to the proximal and distal part. Covariates including age, gender, duration of colonoscopy and comorbidities were defined to determine association between predictors and adenoma detection.
  
  
  RESULTS
  Equal numbers of adenomas were detected in the proximal and distal side of the splenic flexure [126 (57%) vs 94 (43%), P = 0.104]. Simultaneous occurrence of adenomas in both sides of the colon was rare. The appearance of both proximal and distal adenoma was associated with increasing age (P = 0.008 and P = 0.024) and increasing duration of colonoscopy (P < 0.001 and P = 0.001). Male gender was a predictor for adenoma detection in the proximal colon (P = 0.008) but statistical significance was slightly missed with respect to the distal colon (P = 0.089). Alcohol abuse was found to be a predictor for the detection of distal adenoma (P = 0.041).
  
  
  CONCLUSIONS
  Increasing age and longer duration of colonoscopy are factors with a strong impact on adenoma detection both in the proximal and distal colon. Since proximal adenomas occurred in absence of distal adenomas, complete colonoscopy should be performed for screening.
authors.affiliation: Peter Klare, Stefan Ascher, Analena Beitz, Roland M Schmid, Stefan von Delius, II. Medizinische Klinik, Klinikum rechts der Isar, Technischen Universität München, 81675 Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Klare
authors.affiliation: Peter Klare, Stefan Ascher, Analena Beitz, Roland M Schmid, Stefan von Delius, II. Medizinische Klinik, Klinikum rechts der Isar, Technischen Universität München, 81675 Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Ascher
authors.affiliation: Peter Klare, Stefan Ascher, Analena Beitz, Roland M Schmid, Stefan von Delius, II. Medizinische Klinik, Klinikum rechts der Isar, Technischen Universität München, 81675 Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hapfelmeier
authors.affiliation: Peter Klare, Stefan Ascher, Analena Beitz, Roland M Schmid, Stefan von Delius, II. Medizinische Klinik, Klinikum rechts der Isar, Technischen Universität München, 81675 Munich, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Wolf
authors.affiliation: Peter Klare, Stefan Ascher, Analena Beitz, Roland M Schmid, Stefan von Delius, II. Medizinische Klinik, Klinikum rechts der Isar, Technischen Universität München, 81675 Munich, Germany.
authors.forename: Analena
authors.initials: A
authors.lastname: Beitz
authors.affiliation: Peter Klare, Stefan Ascher, Analena Beitz, Roland M Schmid, Stefan von Delius, II. Medizinische Klinik, Klinikum rechts der Isar, Technischen Universität München, 81675 Munich, Germany.
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schmid
authors.affiliation: Peter Klare, Stefan Ascher, Analena Beitz, Roland M Schmid, Stefan von Delius, II. Medizinische Klinik, Klinikum rechts der Isar, Technischen Universität München, 81675 Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: von Delius
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology*; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Adenoma; Colonoscopy; Colorectal carcinoma; Distal; Proximal