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Correspondence
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Volume 336:1761-1762 June 12, 1997 Number 24
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Importance of Colonic Adenomas 5 mm or Less in Diameter

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To the Editor: Several studies have suggested that among persons with tubular adenomas detected by sigmoidoscopy that are diminutive (<5 mm in diameter) or small (6 to 9 mm in diameter) there is not a substantial number of advanced adenomas or cancers found proximally at colonoscopy,1,2 nor is there a subsequent increase in the risk of proximal cancer among those who do not undergo colonoscopy.3 Read et al. (Jan. 2 issue)4 found a substantial prevalence of proximal colonic neoplasms, including advanced lesions, in asymptomatic average-risk patients with diminutive rectosigmoid adenomas and concluded that the finding of such adenomas warrants colonoscopy. . . . [Full Text of this Article]

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