The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Small Polyps Found during Fiberoptic Sigmoidoscopy in Asymptomatic Patients

Edgar Achkar, MD; and William Carey, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: William D. Carey, MD; the Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.

Current Author Addresses: Drs. Achkar and Carey: The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.

© 1988 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1988;109(11):880-883. doi:10.7326/0003-4819-109-11-880
Text Size: A A A

Study Objective: To determine the prevalence of small polyps in the rectosigmoid in an asymptomatic group and the likelihood of finding synchronous neoplastic polyps proximally at colonoscopy.

Design: Asymptomatic patients with polyps 9 mm or less found at screening fiberoptic sigmoidoscopy were referred for colonoscopy, at which time all polyps were removed.

Setting: Screening fiberoptic sigmoidoscopy unit.

Patients: Referral from Executive Health Wellness Clinic and large multispeciality clinic.

Results: From 3923 sigmoidoscopic examinations, 258 asymptomatic subjects (7%) were identified who had polyps 9 mm or smaller. One hundred and eighty-nine patients (73%) had colonoscopy. In 179 patients, the target lesion noted at sigmoidoscopy was identified at colonoscopy. Based on histology of the target lesion, patients were divided into three groups: Group 1 (72 patients) had only hyperplastic polyps; Group 2 (69 patients) had at least one neoplastic polyp; and Group 3 (31 patients) had polyps with normal histology. Seven patients were not classified. Neoplastic polyps were found proximally in 21 patients in Group 1 (29%; 95% CI, 19 to 39), 23 patients in Group 2 (33%; 95% CI, 22 to 44), and 4 patients in Group 3 (13%; 95% CI, 4 to 30). There was no difference in mean age between groups. The results were similar when only polyps 5 mm or smaller were analyzed.

Conclusion: Because small polyps of any histologic type in the rectosigmoid indicate a high risk for having neoplastic polyps proximally, the guidelines of both the American College of Physicians and the American Society of Gastrointestinal Endoscopy may need to be revised. Colonoscopy seems justified in any patient in whom a small polyp is discovered at sigmoidoscopy.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.