The association between location, age and advanced colorectal adenoma characteristics: a propensity-matched analysis.
OBJECTIVE
Evidence supports an association between certain colorectal adenoma characteristics and predisposition to cancer. The association between anatomical location of colorectal adenoma, age and advanced adenomas needs attention. The objective of this study was to evaluate the possible association between occurrence of sporadic advanced adenomas with location and age.


METHODS
A cross-sectional study using baseline data from index colonoscopy from a randomized controlled trial evaluating chemopreventive treatment against recurrence of colorectal adenomas was performed. Inclusion criteria for patients were one adenoma of >1 cm in diameter or multiple adenomas of any size, or an adenoma of any size and familial disposition for colorectal cancer. Multivariate regression and propensity score-matched analyses were used to correlate location of adenomas and age with advanced adenoma features.


RESULTS
In this study, 2149 adenomas were removed in 1215 patients. Advanced colorectal adenomas primarily occurred in the anal part of the colon. Older age was associated with more adenomas and more oral occurrence of adenomas, as well as a higher risk of advanced adenomas. Surprisingly, specifically for the oral adenomas the risk of advanced adenoma seems to be lower for older patients compared with younger.


CONCLUSIONS
This study presents new results with regard to association between age, location of adenomas and risk of advanced adenomas. The results indicate that sigmoidoscopy for screening purposes may be obsolete, and add to the existing literature on which future guidelines for screening may be based.
a Department of Surgery , Hvidovre Hospital - University of Copenhagen , Hvidovre , Denmark.
Hans-Christian
HC
Pommergaard
b Department of Surgery , Zealand University Hospital - University of Copenhagen , Køge , Denmark.
Jakob
J
Burcharth
c Department of Surgery , Herlev Hospital - University of Copenhagen , Herlev , Denmark.
Jacob
J
Rosenberg
d Speciallægecentret ved Diakonissestiftelsen , Frederiksberg , Denmark.
Hans
H
Raskov
D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000175:diagnosis* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003430:Cross-Sectional Studies; D003718:Denmark; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D057216:Propensity Score; D012307:Risk Factors; D012812:Sigmoidoscopy
Adenomas; colorectal; colorectal cancer; polyps; risk factors