Abstract

CARDONA VILLAMIZAR, Héctor José; OTERO REGINO, William; FORERO PINEROS, Elías Alfonso  and  GUTIERREZ CEBALLOS, Oscar. Significado de los pólipos en colon distal, en una población de un país en vía de desarrollo: prevalencia y asociación con neoplasia proximal sincrónica. Rev Col Gastroenterol [online]. 2004, vol.19, n.4, pp.253-262. ISSN 0120-9957.

Colorectal cancer (CCR) represents the second cause of mortality for cancer in the world, with a 5 year survival average less than 55%. The presence of adenomatous polyps constitutes the main risk factor associated to the development of CCR and their early removal has demonstrated to be an effective cost intervention to reduce the incidence of CCR. Prevalence of colonic polyps in countries with high incidence varies between 12%-25% for those of distal location, 21%-27% for proximal location and 9%-13,5% for those with proximal lesions and  synchronous distal polyp. We do not have in lang=EN-US>Colombia studies that evaluate the prevalence and the meaning of the colonic polyps of distal location   Objectives: to estimate the prevalence of polyps in the distal colon (DP) in patients studied with a diagnostic sigmoidoscopy and to calculate the risk of suffering a synchronous proximal neoplasia.  Patient and methods: we used a designed “cross-sectional”, study 4044 patients were studied consecutively, older than 14 years, 3903 (96,5%) completed inclusion criteria. These were applied previously to the endoscopic performance. In the whole of the cases when a polyp was found a colonoscopy was done Results: the general mean age was 48,51 yr (OF = 16,27), 54.3% males. For subjects with DP it was 56,53 yr (OF = 15,53). The prevalence of DP was 8,19% (320/3903), of 7.3% (88/1210) for those of localization proximal and 14,4% (42/980) for those with proximal and synchronous distal lesions. The risk of proximal neoplasia was increased in more than three times with the presence of colonic DP (OR = 3,39, IC 95% 2.14-5.38) and this risk is still bigger in patients with or older than 60 years (OR = 3,99, IC 95% 2,36=6,79 ).  Conclusions: The prevalence of colonic DP (8,19%), proximal (7,3%) and proximal without lesion distal (4,7%) in the studied population is significantly smaller compared with the opposing one in developed countries. Nevertheless, the identification of this lesion in a sigmoidoscopy , independent of the size and of the histological type, increases the probability of a proximal  neoplasia and this finding  indicates  that a colonoscopy must be done. The prevalence of a proximal neoplasia without DP (9%) is similar to that described in developed countries. On the other hand the risk of finding a synchronous proximal neoplasia is ostensibly increased in older than 60 years and therefore we suggest that in this group of patients a complete colonoscopy must be done.

Keywords : polyps; risk factors; colorectal cancer; prevalence.

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