| This retrospective case-control investigation was conducted to further evaluate if hyperplastic polyps (HP) found in the lower 50 cm of colon during routine colorectal cancer (CRC) screening could be used as indicators for synchronous proximal neoplasms (SPN) in the large intestine. Additionally, other characteristics in patients with distal HP were considered as well, including a prior history of gallbladder removal (cholecystectomy), a prior history of appendix removal (appendectomy), a prior history of cancer other than CRC, gender, age, ethnicity, current smoking status, current aspirin/nonsteroidal anti-inflammatory drug (NSAIDS) use, current estrogen/hormone replacement therapy (HRT) use in women, and the size, number, and location of the distal HP. Convenience sampling of pre-existing medical charts and colonoscopy reports compiled over a 10-year period was used to glean the respective sample of 1,792.;The presence of distal HP in the lower 50 cm of colon were not significantly associated with SPN when compared to those without any distal polyps at all X² (1, N = 1,792) = 0.00, p = .95. Hence, routinely recommending a colonoscopy for every patient with distal HP only on a screening flexible sigmoidoscopy (FS) is neither justified nor necessary. A significant relationship was noted with proximal neoplasms if one was known to have a prior diagnosis of cancer X² (1, N = 1,792) = 21.06, p < .01, of advancing age X² (4, N = 1,792) = 19.05, p < .01, a Caucasian male X² (1, n = 1,001) = 7.44, p = .01, a male not taking aspirin/NSAIDS X² (1, n = 1,001) = 3.93, p = .05, or a female actively taking estrogen/HRT X² (1, n = 791) = 3.78, p = .05. In the subsample of patients with just distal HP, only gender (male) was shown to be significantly associated with SPN X² (1, n = 307) = 4.74, p = .03. As such, in those who would otherwise not be advised to receive further testing (i.e., colonoscopy), consideration for such a procedure may need to be entertained in the above cited situations. |
