Clinical Significance of Hyperplastic Polyps in the Distal Colon

ABSTRACT

To determine whether hyperplastic polyps found in the distal colon are associated with proximal adenomas, and to judge whether patients with distal hyperplastic polyps found during sigmoidoscopy might benefit from full colonoscopy. METHODS: We retrospectively analyzed 2333 consecutive patients who were examined with colonoscopy between January 1991 and December 1994. RESULTS: 247 of 2333 patients (10.6%) had one or more colonic polyps. The prevalence of adenomatous polyps alone was 72.5%, hyperplastic polyps 22.7%, and both 0.52%. The proportion of patients with distal hyperplastic polyps and proximal adenomatous polyps (4.4%) was not significantly different from the proportion of those without distal hyperplastic polyps (1.6%). Patients with distal adenomatous polyps, on the other hand, were significantly more likely to have proximal adenomatous polyps than those without distal adenomatous polyps. CONCLUSIONS: Distal hyperplastic polyps are not strong predictors of risk for proximal adenomatous polyps. Based on the results of this study, we do not believe that finding a hyperplastic polyp during sigmoidoscopy justifies doing a full colonoscopy to search for proximal adenomatous polpys.