Digestive Diseases and Sciences

, Volume 51, Issue 12, pp 2206–2212

Risk of Advanced Proximal Adenoma and Cancer According to Rectosigmoid Findings in the Korean Population

  • Yong Woo Chung
  • Dong Soo Han
  • Yoon Kyung Park
  • Byoung Kwan Son
  • Chang Hee Paik
  • Yong Cheol Jeon
  • Joo Hyun Sohn


Colorectal cancer is one of the leading causes of cancer death in the United States and Europe. Recently, the incidence of colorectal cancer has been increasing remarkably in Korea. To reduce the high incidence, screening of colorectal cancer in asymptomatic individuals has been advocated. Sigmoidoscopy is simpler, faster, and better tolerable than total colonoscopy, but the scope cannot reach the proximal colon segment and, therefore, may miss proximal colon cancer. In the present study, we intended to investigate the prevalence of proximal adenoma and cancer according to the findings in rectosigmoid colon and to find their risk factors. Data were collected retrospectively from 1541 consecutive patients who underwent total colonoscopy at the Department of Gastroenterology, Hanyang University, between October 2003 and December 2004. Neoplasms were classified as diminutive adenoma (≤5 mm), small adenoma (6–9 mm), advanced adenoma (≥10 mm, with villous component or high-grade dysplasia), and cancer. The sites of neoplasms were defined as rectosigmoid (rectum and sigmoid colon) and proximal (from cecum to descending colon) colon. The prevalence of advanced proximal adenoma was associated with severe rectosigmoid findings. On the other hand, the prevalence of proximal colon cancer did not show such a tendency. Among the 131 patients with proximal advanced adenoma, 66% had no neoplasm in the rectosigmoid colon. Moreover, among the 27 patients with proximal cancer, 52% had no neoplasm in the rectosigmoid colon. Multivariate logistic regression analysis revealed that age, gender, and advanced rectosigmoid adenoma were the risk factors of advanced proximal adenoma, but nothing was associated with the risk for proximal colon cancer. Advanced rectosigmoid adenoma may be the predictor of advanced proximal adenoma, especially in old males. However, nothing is related to the risk for proximal colon cancer. Therefore, colonoscopy may be more adequate for colorectal cancer screening than sigmoidoscopy in the Korean population.


Rectosigmoid colon Proximal colon Advanced adenoma Colon cancer 


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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Yong Woo Chung
    • 1
  • Dong Soo Han
    • 1
    • 2
  • Yoon Kyung Park
    • 1
  • Byoung Kwan Son
    • 1
  • Chang Hee Paik
    • 1
  • Yong Cheol Jeon
    • 1
  • Joo Hyun Sohn
    • 1
  1. 1.Division of Gastroenterology and Hepatology, Departments of Internal MedicineHanyang University College of MedicineSeoulKorea
  2. 2.Hanyang University Guri HospitalGyomun-dong 249-1Guri-siKorea

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