Detection of proximal XXXX with screening sigmoidoscopy: a systematic review and meta-analysis of screening colonoscopy.

@entity1 @entity1127 @entity5 @entity6523 @entity14 @entity1412
BACKGROUND: The relative effectiveness of flexible sigmoidoscopy compared with colonoscopy to screen for @entity14 depends on the magnitude of the association between findings in the proximal and distal colon and the false-negative rate of screening sigmoidoscopy for proximal @entity5 . To address this, we performed a systematic review and meta-analysis of screening colonoscopy studies. METHODS: Published studies through July 31, 2000, of asymptomatic @entity1 undergoing screening colonoscopy were identified from the MEDLINE database. We generated pooled estimates of the odds ratio for the association between findings in the distal and proximal colon and the prevalence of isolated proximal @entity1412 . RESULTS: Using the sigmoid-descending colon junction to identify the beginning of the distal colon, the pooled odds ratio for the association between distal @entity6523 and any proximal @entity5 was 2.40 (95% confidence interval [CI], 1.42-4.05). Diminutive distal @entity6523 were also associated with proximal @entity5 (odds ratio, 2.36; 95% CI, 1.30-4.29). @entity1127 were not associated with proximal @entity5 (odds ratio, 1.44; 95% CI, 0.79-2.62). The prevalence of isolated advanced proximal @entity5 in the 3 studies was 2%, 3%, and 5%. Using the sigmoid-descending colon junction to identify the beginning of the distal colon yields a pooled estimate of isolated proximal @entity5 of 16.3% (95% CI, 13.6%-19.1%). CONCLUSIONS: Distal @entity6523 , including diminutive distal @entity6523 , are associated with an increased prevalence of @entity5 . Two percent to 5% of @entity1 undergoing screening colonoscopy may have isolated advanced proximal @entity5 . Even more @entity1 may have isolated nonadvanced proximal @entity5 .
