Identification and Predictive Analysis of Colorectal Polyps Using Flexible Sigmoidoscopy: A Retrospective Cohort Study
Predictive Factors of Colorectal Polyps via Sigmoidoscopy
DOI:
https://doi.org/10.69750/dmls.01.02.025Keywords:
Colorectal polyps, Sigmoidoscopy, Predictive factors, Retrospective study, Screening strategies.Abstract
Background: Colorectal polyps are mucosal growths in the colon and rectum that may progress to cancer if not removed early. Flexible sigmoidoscopy is a common diagnostic tool for detecting these polyps, particularly in symptomatic patients, though predictive factors in younger populations remain unclear.
Objective: This study aims to analyze the characteristics of colorectal polyps diagnosed via flexible sigmoidoscopy and identify predictive factors for their presence.
Materials and Methods: We conducted a retrospective study on 1004 patients who underwent sigmoidoscopy from August 2023 to February 2024 at Ghurki Trust & Teaching Hospital, Lahore, Pakistan. The study included data from 84 patients diagnosed with colorectal polyps. Analyzed variables were age, gender, polyp count, type (pedunculated or sessile), distribution, and indications for sigmoidoscopy (bleeding vs. other). Statistical analysis using SPSS version 15 included chi-square tests and odds ratios to identify significant associations.
Results: Colorectal polyps were detected in 8.4% of patients, with a gender distribution of 7.9% in males and 8.4% in females. Sessile polyps predominated at 64.3%, and the majority of polyps were solitary (75%). Polyps primarily affected the rectum (53.6%) and were less frequently found in the sigmoid colon (21.4%), rectosigmoid junction (17.9%), and descending colon (7.1%). Significant predictors of polyp detection included age (45% in children vs. 6.5% in adults, p < 0.001) and indication for sigmoidoscopy (14% in cases of rectal bleeding vs. 3.3% for other reasons, p < 0.001). Gender was not a significant factor (p=0.467).
Conclusion: Sigmoidoscopy effectively detects colorectal polyps, particularly in symptomatic children and those with rectal bleeding. This highlights the need for targeted screening to improve early detection and management. Further research is required to validate these findings and refine screening guidelines.
Downloads
References
Nguyen HH, Bechara R, Paterson WG, Hookey LC. Two-year retrospective analysis of patients undergoing direct to procedure flexible sigmoidoscopy investigation with rectal bleeding as a primary complaint. Endoscopy International Open. 2018;6(08):E1059-E64.
Francois F, Park J, Bini EJ. Colon pathology detected after a positive screening flexible sigmoidoscopy: a prospective study in an ethnically diverse cohort. Official journal of the American College of Gastroenterology| ACG. 2006;101(4):823-30.
Chen S, Sun K, Chao K, Sun Y, Hong L, Weng Z, et al. Detection rate and proximal shift tendency of adenomas and serrated polyps: a retrospective study of 62,560 colonoscopies. International Journal of Colorectal Disease. 2018;33:131-9.
Atkin W, Wooldrage K, Brenner A, Martin J, Shah U, Perera S, et al. Adenoma surveillance and colorectal cancer incidence: a retrospective, multicentre, cohort study. The Lancet Oncology. 2017;18(6):823-34.
Elford AT, Hirsch R, McKay OM, Browne M, Moore GT, Bell S, et al. Identifying the real‐world challenges of dysplasia surveillance in inflammatory bowel disease: a retrospective cohort study in a tertiary health network. Internal Medicine Journal. 2024;54(1):96-103.
Cross AJ, Wooldrage K, Robbins EC, Pack K, Brown JP, Hamilton W, et al. Whole-colon investigation vs. flexible sigmoidoscopy for suspected colorectal cancer based on presenting symptoms and signs: a multicentre cohort study. British Journal of Cancer. 2019;120(2):154-64.
Li W, Chen Z, Chen H, Han X, Zhang G, Zhou X. Establish a Novel Model for Predicting the Risk of Colorectal Ademomatous Polyps: a Prospective Cohort Study. Journal of Cancer. 2022;13(10):3103.
Esteban S, Ricci R, Terrasa S, Kopitowski K. Colonoscopy overuse in colorectal cancer screening and associated factors in Argentina: a retrospective cohort study. BMC gastroenterology. 2017;17:1-7.
Wallace MB, Kemp JA, Trnka YM, Donovan JM, Farraye FA. Is colonoscopy indicated for small adenomas found by screening flexible sigmoidoscopy? Annals of internal medicine. 1998;129(4):273-8.
Tariq H, Kamal MU, Patel H, Patel R, Ameen M, Elona S, et al. Predicting the presence of adenomatous polyps during colonoscopy with National Cancer Institute colorectal Cancer risk-assessment tool. World journal of gastroenterology. 2018;24(34):3919.
Li D, Liu L, Fevrier HB, Alexeeff SE, Doherty AR, Raju M, et al. Increased risk of colorectal cancer in individuals with a history of serrated polyps. Gastroenterology. 2020;159(2):502-11. e2.
Boparai KS, Mathus-Vliegen EM, Koornstra JJ, Nagengast FM, van Leerdam M, van Noesel CJ, et al. Increased colorectal cancer risk during follow-up in patients with hyperplastic polyposis syndrome: a multicentre cohort study. Gut. 2010;59(8):1094-100.
Fairley KJ, Li J, Komar M, Steigerwalt N, Erlich P. Predicting the risk of recurrent adenoma and incident colorectal cancer based on findings of the baseline colonoscopy. Clinical and translational gastroenterology. 2014;5(12):e64.
Bath MF, Malhi A, Ayling RM, Seward E, Pritchard-Jones K, Laszlo HE, et al. Faecal immunochemical testing for haemoglobin in detecting bowel polyps in symptomatic patients: multicentre prospective cohort study. BJS open. 2023;7(2):zrac161.
Kim J, Dobson B, Ng Liet Hing C, Cooper M, Lu CT, Nolan G, et al. Increasing rate of colorectal cancer in younger patients: a review of colonoscopy findings in patients under 50 at a tertiary institution. ANZ Journal of Surgery. 2020;90(12):2484-9.
Carot L, Castells A, Hernández C, Alvarez-Urturi C, Balaguer F, Lanas A, et al. Detection of serrated lesions in proximal colon by simulated sigmoidoscopy vs faecal immunochemical testing in a multicentre, pragmatic, randomised controlled trial. United European gastroenterology journal. 2018;6(10):1527-37.
Li L, Zhang X-Y, Yu J-S, Zhou H-M, Qin Y, Xie W-R, et al. Ability of lactulose breath test results to accurately identify colorectal polyps through the measurement of small intestine bacterial overgrowth. World Journal of Gastrointestinal Surgery. 2023;15(6):1138.
Tanveer M, Qadeer T, Ali SY, Bhatti AA, Khalid R, Suleman M, et al. Physio-Anatomical complications in short and long surgical procedures with General Anesthesia. A comparative cross-sectional study: Anesthesia-Related Physio-Anatomical Complications in surgical procedures. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2024;1(2):20-7.
Atkin W, Wooldrage K, Shah U, Skinner K, Brown JP, Hamilton W, et al. Is whole-colon investigation by colonoscopy, computerised tomography colonography or barium enema necessary for all patients with colorectal cancer symptoms, and for which patients would flexible sigmoidoscopy suffice? A retrospective cohort study. Health Technology Assessment. 2017;21(66).
Muhammad A, Lamendola O, Daas A, Kumar A, Vidyarthi G. Association between colonic diverticulosis and prevalence of colorectal polyps. International journal of colorectal disease. 2014;29:947-51.
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
©The Author(s) . Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/public domain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.