Predictive value of diminutive colonic adenoma trial: The PREDICT trial

Philip Schoenfeld*, Javaid Shad, Eric Ormseth, Walter Coyle, Brooks Cash, James Butler, William Schindler, Walter J. Kikendall, Christopher Furlong, Leslie H. Sobin, Christine M. Hobbs, David Cruess, Douglas Rex

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background & Aims: Diminutive adenomas (1-9 mm in diameter) are frequently found during colon cancer screening with flexible sigmoidoscopy (FS). This trial assessed the predictive value of these diminutive adenomas for advanced adenomas in the proximal colon. Methods: In a multicenter, prospective cohort trial, we matched 200 patients with normal FS and 200 patients with diminutive adenomas on FS for age and gender. All patients underwent colonoscopy. The presence of advanced adenomas (adenoma ≥ 10 mm in diameter, villous adenoma, adenoma with high grade dysplasia, and colon cancer) and adenomas (any size) was recorded. Before colonoscopy, patients completed questionnaires about risk factors for adenomas. Results: The prevalence of advanced adenomas in the proximal colon was similar in patients with diminutive adenomas and patients with normal FS (6% vs. 5.5%, respectively) (relative risk, 1.1; 95% confidence interval [Cl], 0.5-2.6). Diminutive adenomas on FS did not accurately predict advanced adenomas in the proximal colon: sensitivity, 52% (95% Cl, 32%-72%); specificity, 50% (95% Cl, 49%-51%); positive predictive value, 6% (95% Cl, 4%-8%); and negative predictive value, 95% (95% Cl, 92%-97%). Male gender (odds ratio, 1.63; 95% Cl, 1.01-2.61) was associated with an increased risk of proximal colon adenomas. Conclusions: Diminutive adenomas on sigmiodoscopy may not accurately predict advanced adenomas in the proximal colon.

Original languageEnglish
Pages (from-to)195-201
Number of pages7
JournalClinical Gastroenterology and Hepatology
Issue number3
StatePublished - 1 May 2003
Externally publishedYes


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