Incidence of rectosigmoid adenomatous polyps in subjects without prior colorectal adenoma or cancer : a prospective cohort study.
Background-Subjects without known colorectal adenomas or cancer constitute a large majority of the population where 85% of all cases of colorectal cancer are thought to occur.
Consequently these people should be considered for screening to decrease mortality from colorectal cancer in the general population.
Aims-To estimate the incidence rate of rectosigmoid adenomas in these subjects.
Methods-Subjects without adenomas or cancer at a previous examination which had visualised the rectosigmoid underwent a fibre endoscopy every three years.
Endoscopic data and population characteristics were collected prospectively.
A total of 450 subjects fulfilled the selection criteria ; 287 (64%) underwent at least two examinations, and 163 had three or more.
At the second examination, with a mean delay of 39 months, the incidence rate of rectosigmoïd adenomas was 1.50% per patient year.
The rate was 1.75% per patient year (95% CI 0.80-3.33) at the third endoscopy with an additional mean delay of 38 months.
The cumulative incidence rate at six years was 7.3% (95% CI 4.3-10.3), representing a mean of 1.2% per patient year.
This rate increased with age and was higher for men than for women after age adjustment (p<0.03).
Conclusions-The incidence rates are very low compared with those of patients with prior adenomas.
These results should be considered in establishing rectosigmoid adenoma screening strategies.
Mots-clés Pascal : Polype adénomateux, Rectosigmoïde, Epidémiologie, Etude cohorte, Incidence, Dépistage, Carcinome, Rectum, Non existence, Evaluation, Homme, France, Europe, Appareil digestif pathologie, Tumeur bénigne, Tumeur maligne, Intestin pathologie, Rectum pathologie
Mots-clés Pascal anglais : Adenomatous polyp, Rectosigmoid, Epidemiology, Cohort study, Incidence, Medical screening, Carcinoma, Rectum, Non existence, Evaluation, Human, France, Europe, Digestive diseases, Benign neoplasm, Malignant tumor, Intestinal disease, Rectal disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0152342
Code Inist : 002B13B01. Création : 16/11/1999.