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Colonoscopic yield of colorectal neoplasia in daily clinical practice

World Journal of Gastroenterology 2009年第9期15卷 1085-1092页

作者： Jochim S Terhaar sive Droste Mike E Craanen Rene WM van der Hulst Joep F Bartelsman Dick P Bezemer Kim R Cappendijk Gerrit A Meijer Linde M Morsink Pleun Snel Hans ARE Tuynman Roy LJ van Wanrooy Eric IC Wesdorp Chris JJ Mulder Department of Gastroenterology and Hepatology VU University Medical CentrePO Box 70571007 MBAmsterdamThe Netherlands Gastroenterology and Hepatology Kennemer Gasthuis2000 AKHaarlemThe Netherlands Gastroenterology and Hepatology Academic Medical Centre1100 DDAmsterdamThe Netherlands Epidemiology and Biostatistics VU University Medical Centre1007 MBAmsterdamThe Netherlands Pathology VU University Medical Centre1007 MBAmsterdamThe Netherlands Gastroenterology and Hepatology Slotervaart Hospital1006 BKAmsterdamThe Netherlands Gastroenterology and Hepatology Medical Centre Alkmaar1800 AMAlkmaarThe Netherlands Gastroenterology and Hepatology Sint Lucas Andreas Hospital1061 AEAmsterdamThe Netherlands

AIM:To assess the prevalence and location of ad-vanced neoplasia in patients undergoing colonoscopy,and to compare the yield per ***:In a multicenter colonoscopy survey (n = 18 hospitals) in the Amsterdam area (Northern Holland),data of all colonoscopies performed during a three month period in 2005 were analyzed. The location and the histological features of all colonic neoplasia were recorded. The prevalence and the distribution ofadvanced colorectal neoplasia and differences in yield between indication clusters were evaluated. advanced neoplasm was defi ned as adenoma > 10 mm in size,with > 25% villous features or with high-grade dyspla-sia or ***:A total of 4623 eligible patients underwent a total colonoscopy. The prevalence of advanced neo-plasia was 13%,with 281 (6%) adenocarcinomas and 342 (7%) advanced adenomas. Sixty-seven percent and 33% of advanced neoplasia were located in the distal and proximal colon,respectively. Of all patients with right-sided advanced neoplasia (n = 228),51% had a normal distal colon,whereas 27% had a syn-chronous distal adenoma. Ten percent of all colono-scopies were performed in asymptomatic patients,7% of whom had advanced neoplasia. In the respective procedure indication clusters,the prevalence of right-sided advanced neoplasia ranged from 11%-57%. CONCLUSION:One out of every 7-8 colonoscopies yielded an advanced colorectal neoplasm. Colonoscopy is warranted for the evaluation of both symptomatic and asymptomatic patients.

关键词： Colorectal cancer Screening advanced neoplasia Colonoscopy Adenoma

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