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This secondary observational study analyzed UK Flexible Sigmoidoscopy Screening Trial data to relate baseline distal adenoma or hyperplastic polyp characteristics to long-term incident proximal colon cancer. Associations were estimated with multivariable Cox proportional hazards 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distal polyp characteristics were evaluated in the study?","Question",{"text":63,"@type":64},"The study assessed the number and size of distal hyperplastic polyps and adenomas, as well as adenoma histology and dysplasia based on endoscopy and pathology reports.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What were the main findings about adenoma size and dysplasia?",{"text":68,"@type":64},"Larger distal adenomas (6–9 mm and ≥10 mm vs ≤5 mm) and high-grade adenoma dysplasia (vs low-grade) showed positive associations with proximal colon cancer incidence.",{"name":70,"@type":61,"acceptedAnswer":71},"Were hyperplastic polyp features associated with proximal colon cancer risk?",{"text":72,"@type":64},"No associations were observed for the number or size of distal hyperplastic polyps with proximal colon cancer 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risk: a secondary, observational analysis of data from the UK Flexible Sigmoidoscopy Screening Trial  \nRhea Harewood  ,1 Kate Wooldrage  ,1 Emma C Robbins  ,1 James Kinross,2 Christian von Wagner,3 Amanda J Cross  1  \nTo cite: Harewood R, Wooldrage K, Robbins EC, et al. Association of distal adenoma and hyperplastic polyp characteristics with long-term proximal colon cancer risk: a secondary, observational analysis of data from the UK Flexible Sigmoidoscopy Screening Trial. BMJ Open Gastroenterol 2025;12:e001787 . doi:10 . 1136/ bmjgast-2025-001787  \n► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi](https://doi). org/10.1136/bmjgast-2025- 001787) .  \nReceived 13 February 2025 Accepted 4 June 2025  \n© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group. For numbered affiliations see end of article.  \nCorrespondence to  \nDr Rhea Harewood;  \n[r.harewood@imperial.ac.uk](r.harewood@imperial.ac.uk)  \nABSTRACT  \nObjectives Colorectal cancer screening with flexible sigmoidoscopy focuses on the distal colorectum, but it is unclear which distal polyp characteristics are associated with future proximal colon cancer incidence. We examined associations between distal adenoma or hyperplastic polyp characteristics and long-term incident proximal colon cancer.  \nMethods In secondary, observational analyses of UK Flexible Sigmoidoscopy Screening Trial data, we obtained data on the number and size of distal hyperplastic polyps (n=4872) and adenomas (n=4581), adenoma histology and dysplasia from endoscopy and pathology reports for screened asymptomatic participants. Adjusted HRs and 95% CIs for the association between distal polyp characteristics and proximal colon cancer incidence were estimated using multivariable Cox proportional hazard models.  \nResults Over a median of 20.7 years of follow-up (IQR 16.5–21.7), 110 proximal colon cancers were diagnosed among participants with distal adenomas and 96 were diagnosed among those with only distal hyperplastic polyps detected at baseline. Larger adenoma size (6–9 mm vs ≤5 mm: HR 1.67 (95%CI: 1.07 to 2 .59) and ≥10 mm vs ≤5 mm: HR 2.08 (95%CI: 0.98 to 4 .43); p=0 .037) and high-grade (vs low-grade) adenoma dysplasia (HR 2.82, 95% CI: 1.34 to 5 .93; p=0 .012) at baseline were positively associated with proximal colon cancer incidence. No associations were observed for distal adenoma number overall or histology, or the number or size of hyperplastic polyps and proximal colon cancer incidence.  \nConclusions We found some evidence that larger distal adenomas and those with high-grade dysplasia at baseline were positively associated with proximal colon cancer incidence. Larger studies are needed to confirm these findings. Trial registration number ISRCTN28352761 .  \nINTRODUCTION  \nColorectal cancer was estimated to be the third most common cancer and second most  \ncommon cause of cancer death globally in  \nWHAT IS ALREADY KNOWN ON THIS TOPIC  \n\n| ⇒ Previous studies (using flexible sigmoidoscopy trial data) have reported associations between baseline distal adenoma number and size and synchronous baseline proximal adenomas and between baseline distal adenoma number, size and histology and synchronous baseline advanced proximal neoplasia.\u003Cbr>⇒ To our knowledge, no previous study has investigated the association between distal polyp findings and long-term proximal colon cancer risk.\u003Cbr>WHAT THIS STUDY ADDS |\n| --- |\n| ⇒ We examined if distal findings were associated with long-term (21 years of follow-up) proximal colon cancer incidence among asymptomatic individuals with distal polyps detected at baseline screening flexible sigmoidoscopy.\u003Cbr>⇒ We found that distal adenoma size (>5 mm vs ≤5 mm) and distal adenoma dysplasia (high-grade vs low-grade) were associated with a higher r","cbCaimZjaMiqyAhn","https://ap.wps.com/l/cbCaimZjaMiqyAhn","pdf",910637,11,"English","# Abstract\n## Objectives\n## Methods\n## Results\n## Conclusions\n# Introduction\n# What is already known on this topic\n# What this study adds\n# How this study might affect research, practice or policy","[{\"question\":\"What distal polyp characteristics were evaluated in the study?\",\"answer\":\"The study assessed the number and size of distal hyperplastic polyps and adenomas, as well as adenoma histology and dysplasia based on endoscopy and pathology reports.\"},{\"question\":\"What were the main findings about adenoma size and dysplasia?\",\"answer\":\"Larger distal adenomas (6–9 mm and ≥10 mm vs ≤5 mm) and high-grade adenoma dysplasia (vs low-grade) showed positive associations with proximal colon cancer incidence.\"},{\"question\":\"Were hyperplastic polyp features associated with proximal colon cancer risk?\",\"answer\":\"No associations were observed for the number or size of distal hyperplastic polyps with proximal colon cancer incidence.\"}]","Colorectal cancer - Association of distal adenoma and hyperplastic polyp characteristics with long-term proximal colon cancer risk | PDF",1790199657,28]