Background and Methods The clinical significance of a distalcolorectal polyp is uncertain. We determined the risk of advancedproximal neoplasia, defined as a polyp with villous features,a polyp with high-grade dysplasia, or cancer, among personswith distal hyperplastic or neoplastic polyps as compared withthe risk among persons with no distal polyps. We analyzed datafrom 1994 consecutive asymptomatic adults (age, 50 years orolder) who underwent colonoscopic screening for the first timebetween September 1995 and December 1998 as part of a programsponsored by an employer. The location and histologic featuresof all polyps were recorded. Colonoscopy to the level of thececum was completed in 97.0 percent of the patients.
Results Sixty-one patients (3.1 percent) had advanced lesionsin the distal colon, including 5 with cancer, and 50 (2.5 percent)had advanced proximal lesions, including 7 with cancer. Twenty-threepatients with advanced proximal neoplasms (46 percent) had nodistal polyps. The prevalence of advanced proximal neoplasiaamong patients with no distal polyps was 1.5 percent (23 casesamong 1564 persons; 95 percent confidence interval, 0.9 to 2.1percent). Among patients with distal hyperplastic polyps, thosewith distal tubular adenomas, and those with advanced distalpolyps, the prevalence of advanced proximal neoplasia was 4.0percent (8 cases among 201 patients), 7.1 percent (12 casesamong 168 patients), and 11.5 percent (7 cases among 61 patients),respectively. The relative risk of advanced proximal neoplasia,adjusted for age and sex, was 2.6 for patients with distal hyperplasticpolyps, 4.0 for those with distal tubular adenomas, and 6.7for those with advanced distal polyps, as compared with patientswho had no distal polyps. Older age and male sex were associatedwith an increased risk of advanced proximal neoplasia (relativerisk, 1.3 for every five years of age and 3.3 for male sex).
Conclusions Asymptomatic persons 50 years of age or older whohave polyps in the distal colon are more likely to have advancedproximal neoplasia than are persons without distal polyps. However,if colonoscopic screening is performed only in persons withdistal polyps, about half the cases of advanced proximal neoplasiawill not be detected.
Source Information
From the Departments of Medicine, Indiana University Medical Center and Roudebush Veterans Affairs Medical Center (T.F.I., C.Y.L.); the Indianapolis Gastroenterology Research Foundation (D.R.W., J.D.R.); and Eli Lilly (G.N.L.) — all in Indianapolis; and the Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (D.F.R.).
Address reprint requests to Dr. Imperiale at Indiana University Medical Center, Division of Gastroenterology, 975 W. Walnut St., IB-424, Indianapolis, IN 46202-5121.
Hassan, C., Hunink, M. G. M., Laghi, A., Pickhardt, P. J., Zullo, A., Kim, D. H., Iafrate, F., Di Giulio, E.
(2009). Value-of-Information Analysis to Guide Future Research in Colorectal Cancer Screening. Radiology
253: 745-752
[Abstract][Full Text]
Lieberman, D. A.
(2009). Screening for Colorectal Cancer. NEJM
361: 1179-1187
[Full Text]
Pickhardt, P. J., Kim, D. H.
(2009). Colorectal Cancer Screening With CT Colonography: Key Concepts Regarding Polyp Prevalence, Size, Histology, Morphology, and Natural History. Am. J. Roentgenol.
193: 40-46
[Abstract][Full Text]
Pickhardt, P. J., Hassan, C., Laghi, A., Kim, D. H.
(2009). CT Colonography to Screen for Colorectal Cancer and Aortic Aneurysm in the Medicare Population: Cost-Effectiveness Analysis. Am. J. Roentgenol.
192: 1332-1340
[Abstract][Full Text]
Hassan, C., Pickhardt, P. J., Laghi, A., Zullo, A., Kim, D. H., Iafrate, F., Di Giulio, L., Morini, S.
(2009). Impact of Whole-Body CT Screening on the Cost-effectiveness of CT Colonography. Radiology
251: 156-165
[Abstract][Full Text]
Wilkins, T., LeClair, B., Smolkin, M., Davies, K., Thomas, A., Taylor, M. L., Strayer, S.
(2009). Screening Colonoscopies by Primary Care Physicians: A Meta-Analysis. Ann Fam Med
7: 56-62
[Abstract][Full Text]
Kaltenbach, T, Friedland, S, Soetikno, R
(2008). A randomised tandem colonoscopy trial of narrow band imaging versus white light examination to compare neoplasia miss rates. Gut
57: 1406-1412
[Abstract][Full Text]
Lieberman, D. A., Holub, J. L., Moravec, M. D., Eisen, G. M., Peters, D., Morris, C. D.
(2008). Prevalence of Colon Polyps Detected by Colonoscopy Screening in Asymptomatic Black and White Patients. JAMA
300: 1417-1422
[Abstract][Full Text]
Imperiale, T. F., Glowinski, E. A., Lin-Cooper, C., Larkin, G. N., Rogge, J. D., Ransohoff, D. F.
(2008). Five-Year Risk of Colorectal Neoplasia after Negative Screening Colonoscopy. NEJM
359: 1218-1224
[Abstract][Full Text]
Sung, J J Y, Lau, J Y W, Young, G P, Sano, Y, Chiu, H M, Byeon, J S, Yeoh, K G, Goh, K L, Sollano, J, Rerknimitr, R, Matsuda, T, Wu, K C, Ng, S, Leung, S Y, Makharia, G, Chong, V H, Ho, K Y, Brooks, D, Lieberman, D A, Chan, F K L, for The Asia Pacific Working Group on Colorectal C,
(2008). Asia Pacific consensus recommendations for colorectal cancer screening. Gut
57: 1166-1176
[Abstract][Full Text]
Levin, B., Lieberman, D. A., McFarland, B., Smith, R. A., Brooks, D., Andrews, K. S., Dash, C., Giardiello, F. M., Glick, S., Levin, T. R., Pickhardt, P., Rex, D. K., Thorson, A., Winawer, S. J., for the American Cancer Society Colorectal Cancer,
(2008). Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin
58: 130-160
[Abstract][Full Text]
Hassan, C., Pickhardt, P., Laghi, A., Kim, D., Zullo, A., Iafrate, F., Di Giulio, L., Morini, S.
(2008). Computed Tomographic Colonography to Screen for Colorectal Cancer, Extracolonic Cancer, and Aortic Aneurysm: Model Simulation With Cost-effectiveness Analysis. Arch Intern Med
168: 696-705
[Abstract][Full Text]
Rex, D. K., Imperiale, T. F., Regula, J., Polkowski, M., Glaser, D. S., Butterly, L. F., Pohl, H., Kim, D. H., Pickhardt, P. J.
(2008). CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia. NEJM
358: 88-90
[Full Text]
Pickhardt, P. J., Hassan, C., Laghi, A., Zullo, A., Kim, D. H., Iafrate, F., Morini, S.
(2008). Small and Diminutive Polyps Detected at Screening CT Colonography: A Decision Analysis for Referral to Colonoscopy. Am. J. Roentgenol.
190: 136-144
[Abstract][Full Text]
Bujanda, L., Sarasqueta, C., Zubiaurre, L., Cosme, A., Munoz, C., Sanchez, A., Martin, C., Tito, L., Pinol, V., Castells, A., Llor, X., Xicola, R. M, Pons, E., Clofent, J., de Castro, M. L, Cuquerella, J., Medina, E., Gutierrez, A., Arenas, J. I, Jover, R., for the EPICOLON Group,
(2007). Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer. Gut
56: 1714-1718
[Abstract][Full Text]
Brenner, H., Hoffmeister, M., Stegmaier, C., Brenner, G., Altenhofen, L., Haug, U.
(2007). Risk of progression of advanced adenomas to colorectal cancer by age and sex: estimates based on 840 149 screening colonoscopies. Gut
56: 1585-1589
[Abstract][Full Text]
Kim, D. H., Pickhardt, P. J., Taylor, A. J., Leung, W. K., Winter, T. C., Hinshaw, J. L., Gopal, D. V., Reichelderfer, M., Hsu, R. H., Pfau, P. R.
(2007). CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia. NEJM
357: 1403-1412
[Abstract][Full Text]
Knox, L., Hahn, R. G., Lane, C.
(2007). A Comparison of Unsedated Colonoscopy and Flexible Sigmoidoscopy in the Family Medicine Setting: An LA Net Study. J Am Board Fam Med
20: 444-450
[Abstract][Full Text]
Yoshida, D., Kono, S., Moore, M. A, Toyomura, K., Nagano, J., Mizoue, T., Mibu, R., Tanaka, M., Kakeji, Y., Maehara, Y., Okamura, T., Ikejiri, K., Futami, K., Yasunami, Y., Maekawa, T., Takenaka, K., Ichimiya, H., Imaizumi, N.
(2007). Colorectal Polypectomy and Risk of Colorectal Cancer by Subsite: The Fukuoka Colorectal Cancer Study. Jpn J Clin Oncol
0: hym065v1-6
[Abstract][Full Text]
McDonnell, W. M., Loura, F.
(2007). Complications of Colonoscopy. ANN INTERN MED
147: 212-213
[Full Text]
O'Dwyer, P. J., Eckhardt, S. G., Haller, D. G., Tepper, J., Ahnen, D., Hamilton, S., Benson, A. B. III, Rothenberg, M., Petrelli, N., Lenz, H.-J., Diasio, R., DuBois, R., Sargent, D., Sloan, J., Johnson, C. D., Comis, R. L., O'Connell, M. J.
(2007). Priorities in Colorectal Cancer Research: Recommendations From the Gastrointestinal Scientific Leadership Council of the Coalition of Cancer Cooperative Groups. JCO
25: 2313-2321
[Abstract][Full Text]
Brenner, H., Chang-Claude, J., Seiler, C. M., Sturmer, T., Hoffmeister, M.
(2007). Potential for Colorectal Cancer Prevention of Sigmoidoscopy Versus Colonoscopy: Population-Based Case Control Study. Cancer Epidemiol. Biomarkers Prev.
16: 494-499
[Abstract][Full Text]
Latreille, M. W., Anderson, J. C., Maisonneuve, P., Lowenfels, A. B., Picca, S. M., Regula, J., Polkowski, M., Butruk, E.
(2007). Colonoscopy Screening for Detection of Advanced Neoplasia. NEJM
356: 632-634
[Full Text]
Ashton-Sager, A., Wu, M. L.-c.
(2007). Incidental Rectal Mucosa Obtained via Transrectal Ultrasound-Guided Prostatic Core Biopsies. INT J SURG PATHOL
15: 26-30
[Abstract]
Levin, T. R., Zhao, W., Conell, C., Seeff, L. C., Manninen, D. L., Shapiro, J. A., Schulman, J.
(2006). Complications of Colonoscopy in an Integrated Health Care Delivery System. ANN INTERN MED
145: 880-886
[Abstract][Full Text]
Lieberman, D.
(2006). A Call to Action -- Measuring the Quality of Colonoscopy. NEJM
355: 2588-2589
[Full Text]
El-Serag, H. B., Petersen, L., Hampel, H., Richardson, P., Cooper, G.
(2006). The use of screening colonoscopy for patients cared for by the department of veterans affairs.. Arch Intern Med
166: 2202-2208
[Abstract][Full Text]
Boolchand, V., Olds, G., Singh, J., Singh, P., Chak, A., Cooper, G. S.
(2006). Colorectal screening after polypectomy: a national survey study of primary care physicians.. ANN INTERN MED
145: 654-659
[Abstract][Full Text]
Regula, J., Rupinski, M., Kraszewska, E., Polkowski, M., Pachlewski, J., Orlowska, J., Nowacki, M. P., Butruk, E.
(2006). Colonoscopy in Colorectal-Cancer Screening for Detection of Advanced Neoplasia. NEJM
355: 1863-1872
[Abstract][Full Text]
(2006). Population screening for colorectal cancer. DTB
44: 65-68
[Abstract][Full Text]
Bleiberg, H., Autier, P., Huet, F., Schrauwen, A. M., Staquet, E., Delaunoit, T., Hendlisz, A., Wyns, C., Panzer, J. M., Caucheteur, B., Eisendrath, P., Grivegnee, A.
(2006). Colorectal cancer (CRC) screening using sigmoidoscopy followed by colonoscopy: a feasibility and efficacy study on a cancer institute based population. Ann Oncol
17: 1328-1332
[Abstract][Full Text]
Singh, H., Turner, D., Xue, L., Targownik, L. E., Bernstein, C. N.
(2006). Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies.. JAMA
295: 2366-2373
[Abstract][Full Text]
Winawer, S. J., Zauber, A. G., Fletcher, R. H., Stillman, J. S., O'Brien, M. J., Levin, B., Smith, R. A., Lieberman, D. A., Burt, R. W., Levin, T. R., Bond, J. H., Brooks, D., Byers, T., Hyman, N., Kirk, L., Thorson, A., Simmang, C., Johnson, D., Rex, D. K.
(2006). Guidelines for Colonoscopy Surveillance after Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society.. CA Cancer J Clin
56: 143-159
[Abstract][Full Text]
Rex, D. K., Kahi, C. J., Levin, B., Smith, R. A., Bond, J. H., Brooks, D., Burt, R. W., Byers, T., Fletcher, R. H., Hyman, N., Johnson, D., Kirk, L., Lieberman, D. A., Levin, T. R., O'Brien, M. J., Simmang, C., Thorson, A. G., Winawer, S. J.
(2006). Guidelines for Colonoscopy Surveillance after Cancer Resection: A Consensus Update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer.. CA Cancer J Clin
56: 160-167
[Abstract][Full Text]
Haug, U., Wente, M. N., Seiler, C. M., Rothenbacher, D., Buchler, M. W., Brenner, H.
(2006). Tumor m2 pyruvate kinase as a stool marker for colorectal cancer: stability at room temperature and implications for application in the screening setting.. Clin. Chem.
52: 782-784
[Full Text]
Zisman, A. L., Nickolov, A., Brand, R. E., Gorchow, A., Roy, H. K.
(2006). Associations between the age at diagnosis and location of colorectal cancer and the use of alcohol and tobacco: implications for screening.. Arch Intern Med
166: 629-634
[Abstract][Full Text]
Taylor, W. C.
(2006). A 71-Year-Old Woman Contemplating a Screening Colonoscopy. JAMA
295: 1161-1167
[Full Text]
Iannaccone, R., Catalano, C., Mangiapane, F., Murakami, T., Lamazza, A., Fiori, E., Schillaci, A., Marin, D., Nofroni, I., Hori, M., Passariello, R.
(2005). Colorectal Polyps: Detection with Low-Dose Multi-Detector Row Helical CT Colonography versus Two Sequential Colonoscopies. Radiology
237: 927-937
[Abstract][Full Text]
Macari, M., Bini, E. J.
(2005). CT Colonography: Where Have We Been and Where Are We Going?. Radiology
237: 819-833
[Abstract][Full Text]
Levin, T. R., Atkin, W. S., Thomas, C. M., Schoenfeld, P., Lieberman, D.
(2005). Colonoscopic Screening of Women for Colorectal Neoplasia. NEJM
353: 844-846
[Full Text]
Eisen, G. M., Weinberg, D. S.
(2005). Narrative Review: Screening for Colorectal Cancer in Patients with a First-Degree Relative with Colonic Neoplasia. ANN INTERN MED
143: 190-198
[Abstract][Full Text]
Levin, T R, Farraye, F A, Schoen, R E, Hoff, G, Atkin, W, Bond, J H, Winawer, S, Burt, R W, Johnson, D A, Kirk, L M, Litin, S C, Rex, D K
(2005). Quality in the technical performance of screening flexible sigmoidoscopy: recommendations of an international multi-society task group. Gut
54: 807-813
[Abstract][Full Text]
Schoenfeld, P., Cash, B., Flood, A., Dobhan, R., Eastone, J., Coyle, W., Kikendall, J. W., Kim, H. M., Weiss, D. G., Emory, T., Schatzkin, A., Lieberman, D., the CONCeRN Study Investigators,
(2005). Colonoscopic Screening of Average-Risk Women for Colorectal Neoplasia. NEJM
352: 2061-2068
[Abstract][Full Text]
Segnan, N., Senore, C., Andreoni, B., Arrigoni, A., Bisanti, L., Cardelli, A., Castiglione, G., Crosta, C., DiPlacido, R., Ferrari, A., Ferraris, R., Ferrero, F., Fracchia, M., Gasperoni, S., Malfitana, G., Recchia, S., Risio, M., Rizzetto, M., Saracco, G., Spandre, M., Turco, D., Turco, P., Zappa, M., SCORE2 Working Group-Italy,
(2005). Randomized Trial of Different Screening Strategies for Colorectal Cancer: Patient Response and Detection Rates. JNCI J Natl Cancer Inst
97: 347-357
[Abstract][Full Text]
Lin, O. S., Gerson, L. B., Soon, M.-S., Schembre, D. B., Kozarek, R. A.
(2005). Risk of Proximal Colon Neoplasia With Distal Hyperplastic Polyps: A Meta-analysis. Arch Intern Med
165: 382-390
[Abstract][Full Text]
Hawk, E. T., Levin, B.
(2005). Colorectal Cancer Prevention. JCO
23: 378-391
[Abstract][Full Text]
Terzolo, M., Reimondo, G., Gasperi, M., Cozzi, R., Pivonello, R., Vitale, G., Scillitani, A., Attanasio, R., Cecconi, E., Daffara, F., Gaia, E., Martino, E., Lombardi, G., Angeli, A., Colao, A.
(2005). Colonoscopic Screening and Follow-Up in Patients with Acromegaly: A Multicenter Study in Italy. J. Clin. Endocrinol. Metab.
90: 84-90
[Abstract][Full Text]
Fearnhead, N. S., Wilding, J. L., Winney, B., Tonks, S., Bartlett, S., Bicknell, D. C., Tomlinson, I. P. M., Mortensen, N. J. McC., Bodmer, W. F.
(2004). Multiple rare variants in different genes account for multifactorial inherited susceptibility to colorectal adenomas. Proc. Natl. Acad. Sci. USA
101: 15992-15997
[Abstract][Full Text]
Chao, A., Connell, C. J., Cokkinides, V., Jacobs, E. J., Calle, E. E., Thun, M. J.
(2004). Underuse of Screening Sigmoidoscopy and Colonoscopy in a Large Cohort of US Adults. AJPH
94: 1775-1781
[Abstract][Full Text]
Mysliwiec, P. A., Brown, M. L., Klabunde, C. N., Ransohoff, D. F.
(2004). Are Physicians Doing Too Much Colonoscopy? A National Survey of Colorectal Surveillance after Polypectomy. ANN INTERN MED
141: 264-271
[Abstract][Full Text]
Wu, X., Chen, V. W., Martin, J., Roffers, S., Groves, F. D., Correa, C. N., Hamilton-Byrd, E., Jemal, A.
(2004). Subsite-Specific Colorectal Cancer Incidence Rates and Stage Distributions among Asians and Pacific Islanders in the United States, 1995 to 1999. Cancer Epidemiol. Biomarkers Prev.
13: 1215-1222
[Abstract][Full Text]
Ransohoff, D. F.
(2004). Virtual Colonoscopy--What It Can Do vs What It Will Do. JAMA
291: 1772-1774
[Full Text]
Yamaji, Y, Mitsushima, T, Ikuma, H, Watabe, H, Okamoto, M, Kawabe, T, Wada, R, Doi, H, Omata, M
(2004). Incidence and recurrence rates of colorectal adenomas estimated by annually repeated colonoscopies on asymptomatic Japanese. Gut
53: 568-572
[Abstract][Full Text]
Macari, M., Bini, E. J., Jacobs, S. L., Naik, S., Lui, Y. W., Milano, A., Rajapaksa, R., Megibow, A. J., Babb, J.
(2004). Colorectal Polyps and Cancers in Asymptomatic Average-Risk Patients: Evaluation with CT Colonography. Radiology
230: 629-636
[Abstract][Full Text]
Colao, A., Ferone, D., Marzullo, P., Lombardi, G.
(2004). Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management. Endocr. Rev.
25: 102-152
[Abstract][Full Text]
Murray, M A, Zimmerman, M J, Ee, H C
(2004). Sporadic duodenal adenoma is associated with colorectal neoplasia. Gut
53: 261-265
[Abstract][Full Text]
Imperiale, T. F., Wagner, D. R., Lin, C. Y., Larkin, G. N., Rogge, J. D., Ransohoff, D. F.
(2003). Using Risk for Advanced Proximal Colonic Neoplasia To Tailor Endoscopic Screening for Colorectal Cancer. ANN INTERN MED
139: 959-965
[Abstract][Full Text]
Winawer, S. J.
(2003). Screening Sigmoidoscopy: Can the Road to Colonoscopy Be Less Traveled?. ANN INTERN MED
139: 1034-1035
[Full Text]
Lieberman, D. A., Prindiville, S., Weiss, D. G., Willett, W.
(2003). Risk Factors for Advanced Colonic Neoplasia and Hyperplastic Polyps in Asymptomatic Individuals. JAMA
290: 2959-2967
[Abstract][Full Text]
Morrin, M. M., LaMont, J. T.
(2003). Screening Virtual Colonoscopy -- Ready for Prime Time?. NEJM
349: 2261-2264
[Full Text]
Herfarth, H, Schreyer, A G
(2003). The virtuosity of virtuality or how real is virtual colonography. Gut
52: 1662-1664
[Full Text]
Wiesner, G. L., Daley, D., Lewis, S., Ticknor, C., Platzer, P., Lutterbaugh, J., MacMillen, M., Baliner, B., Willis, J., Elston, R. C., Markowitz, S. D.
(2003). A subset of familial colorectal neoplasia kindreds linked to chromosome 9q22.2-31.2. Proc. Natl. Acad. Sci. USA
100: 12961-12965
[Abstract][Full Text]
Sonnenberg, A., Lieberman, D.
(2003). Optimal Intervals and Techniques for Screening Sigmoidoscopy. JAMA
290: 2122-2123
[Full Text]
Schoen, R. E.
(2003). Prevalence of Isolated Advanced Proximal Neoplasia. Arch Intern Med
163: 2103-2103
[Full Text]
Chan, T. L., Zhao, W., Cancer Genome Project, , Leung, S. Y., Yuen, S. T.
(2003). BRAF and KRAS Mutations in Colorectal Hyperplastic Polyps and Serrated Adenomas. Cancer Res.
63: 4878-4881
[Abstract][Full Text]
Schoen, R. E., Pinsky, P. F., Weissfeld, J. L., Bresalier, R. S., Church, T., Prorok, P., Gohagan, J. K.
(2003). Results of Repeat Sigmoidoscopy 3 Years After a Negative Examination. JAMA
290: 41-48
[Abstract][Full Text]
Walsh, J. M. E., Terdiman, J. P.
(2003). Colorectal Cancer Screening: Scientific Review. JAMA
289: 1288-1296
[Abstract][Full Text]
Watson, A J M
(2003). Are proximal colorectal cancers always associated with distal adenomas?. Gut
52: 317-318
[Full Text]
Gondal, G, Grotmol, T, Hofstad, B, Bretthauer, M, Eide, T J, Hoff, G
(2003). Grading of distal colorectal adenomas as predictors for proximal colonic neoplasia and choice of endoscope in population screening: experience from the Norwegian Colorectal Cancer Prevention study (NORCCAP). Gut
52: 398-403
[Abstract][Full Text]
Lewis, J. D., Ng, K., Hung, K. E., Bilker, W. B., Berlin, J. A., Brensinger, C., Rustgi, A. K.
(2003). Detection of Proximal Adenomatous Polyps With Screening Sigmoidoscopy: A Systematic Review and Meta-analysis of Screening Colonoscopy. Arch Intern Med
163: 413-420
[Abstract][Full Text]
Moayyedi, P., Ford, A.
(2002). Recent developments in gastroenterology. BMJ
325: 1399-1402
[Full Text]
Segnan, N., Senore, C., Andreoni, B., Aste, H., Bonelli, L., Crosta, C., Ferraris, R., Gasperoni, S., Penna, A., Risio, M., Rossini, F. P., Sciallero, S., Zappa, M., Atkin, W. S.
(2002). Baseline Findings of the Italian Multicenter Randomized Controlled Trial of "Once-Only Sigmoidoscopy"--SCORE. JNCI J Natl Cancer Inst
94: 1763-1772
[Abstract][Full Text]
Lin, H. J., Lakkides, K. M., Keku, T. O., Reddy, S. T., Louie, A. D., Kau, I. H., Zhou, H., Gim, J. S. Y., Ma, H. L., Matthies, C. F., Dai, A., Huang, H.-F., Materi, A. M., Lin, J. H., Frankl, H. D., Lee, E. R., Hardy, S. I., Herschman, H. R., Henderson, B. E., Kolonel, L. N., Le Marchand, L., Garavito, R. M., Sandler, R. S., Haile, R. W., Smith, W. L.
(2002). Prostaglandin H Synthase 2 Variant (Val511Ala) in African Americans May Reduce the Risk for Colorectal Neoplasia. Cancer Epidemiol. Biomarkers Prev.
11: 1305-1315
[Abstract][Full Text]
Romagnuolo, J., Chatterton, H. T., Imperiale, T. F., Ransohoff, D. F.
(2002). Screening Colonoscopy among Persons 40 to 49 Years of Age. NEJM
347: 1205-1206
[Full Text]
Swaroop, V. S., Larson, M. V.
(2002). Colonoscopy as a Screening Test for Colorectal Cancer in Average-Risk Individuals. Mayo Clin Proc.
77: 951-956
[Abstract]
Anderson, W. F., Guyton, K. Z., Hiatt, R. A., Vernon, S. W., Levin, B., Hawk, E.
(2002). Colorectal Cancer Screening for Persons at Average Risk. JNCI J Natl Cancer Inst
94: 1126-1133
[Full Text]
Pignone, M., Rich, M., Teutsch, S. M., Berg, A. O., Lohr, K. N.
(2002). Screening for Colorectal Cancer in Adults at Average Risk: A Summary of the Evidence for the U.S. Preventive Services Task Force. ANN INTERN MED
137: 132-141
[Abstract][Full Text]
Imperiale, T. F., Wagner, D. R., Lin, C. Y., Larkin, G. N., Rogge, J. D., Ransohoff, D. F.
(2002). Results of Screening Colonoscopy among Persons 40 to 49 Years of Age. NEJM
346: 1781-1785
[Abstract][Full Text]
Chong, A., Shah, J. N., Levine, M. S., Rubesin, S. E., Laufer, I., Ginsberg, G. G., Long, W. B., Kochman, M. L.
(2002). Diagnostic Yield of Barium Enema Examination after Incomplete Colonoscopy. Radiology
223: 620-624
[Abstract][Full Text]
Traverso, G., Shuber, A., Levin, B., Johnson, C., Olsson, L., Schoetz, D. J. Jr., Hamilton, S. R., Boynton, K., Kinzler, K. W., Vogelstein, B.
(2002). Detection of APC Mutations in Fecal DNA from Patients with Colorectal Tumors. NEJM
346: 311-320
[Abstract][Full Text]
Autier, P.
(2002). Should organised faecal occult blood test screening be established?. Ann Oncol
13: 57-60
[Full Text]
Lewis, J. D., Brown, A., Localio, A. R., Schwartz, J. S.
(2002). Initial Evaluation of Rectal Bleeding in Young Persons: A Cost-Effectiveness Analysis. ANN INTERN MED
136: 99-110
[Abstract][Full Text]
Ransohoff, D. F., Sandler, R. S.
(2002). Screening for Colorectal Cancer. NEJM
346: 40-44
[Full Text]
Winawer, S. J.
(2001). A Quarter Century of Colorectal Cancer Screening: Progress and Prospects. JCO
19: 6s-12
[Full Text]
Cunningham, J., Doerr, T. D., Walter, L. C., Covinsky, K. E.
(2001). Discussing Cancer Screening With Elderly Patients. JAMA
286: 1175-1176
[Full Text]
Hawkins, N. J., Ward, R. L.
(2001). Sporadic Colorectal Cancers With Microsatellite Instability and Their Possible Origin in Hyperplastic Polyps and Serrated Adenomas. JNCI J Natl Cancer Inst
93: 1307-1313
[Abstract][Full Text]
Lieberman, D. A., Harford, W. V., Ahnen, D. J., Provenzale, D., Sontag, S. J., Schnell, T. G., Chejfec, G., Campbell, D. R., Durbin, T. E., Bond, J. H., Nelson, D. B., Ewing, S. L., Triadafilopoulos, G., Ramirez, F. C., Lee, J. G., Collins, J. F., Fennerty, M. B., Johnston, T. K., Corless, C. L., McQuaid, K. R., Garewal, H., Sampliner, R. E., Morales, T. G., Fass, R., Smith, R. E., Maheshwari, Y., Weiss, D. G., the Veterans Affairs Cooperative Study Group 380,
(2001). One-Time Screening for Colorectal Cancer with Combined Fecal Occult-Blood Testing and Examination of the Distal Colon. NEJM
345: 555-560
[Abstract][Full Text]
Detsky, A. S.
(2001). Screening for Colon Cancer -- Can We Afford Colonoscopy?. NEJM
345: 607-608
[Full Text]
Jenkins, P. J., Besser, M.
(2001). CLINICAL PERSPECTIVE: Acromegaly and Cancer: A Problem. J. Clin. Endocrinol. Metab.
86: 2935-2941
[Full Text]
WINAWER, S J, ZAUBER, A G
(2001). Colonoscopic polypectomy and the incidence of colorectal cancer. Gut
48: 753-754
[Full Text]
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