TY - JOUR
T1 - Predictive value of diminutive colonic adenoma trial
T2 - The PREDICT trial
AU - Schoenfeld, Philip
AU - Shad, Javaid
AU - Ormseth, Eric
AU - Coyle, Walter
AU - Cash, Brooks
AU - Butler, James
AU - Schindler, William
AU - Kikendall, Walter J.
AU - Furlong, Christopher
AU - Sobin, Leslie H.
AU - Hobbs, Christine M.
AU - Cruess, David
AU - Rex, Douglas
N1 - Funding Information:
Supported by grants from the American College of Gastroenterology, the American Society for Gastrointestinal Endoscopy, and American Digestive Health Foundation.
Funding Information:
Dr. Schoenfeld's research is supported by an NIDDK Career Development Award, K-23-DK-60040-01.
PY - 2003/5/1
Y1 - 2003/5/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=10744233287&partnerID=8YFLogxK
U2 - 10.1016/S1542-3565(03)70036-6
DO - 10.1016/S1542-3565(03)70036-6
M3 - Article
C2 - 15017491
AN - SCOPUS:10744233287
SN - 1542-3565
VL - 1
SP - 195
EP - 201
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 3
ER -