Use of colonoscopy to screen asymptomatic adults for colorectal cancer

David Lieberman, David G. Weiss, John H. Bond, Dennis J. Ahnen, Harinder Garewal, Gregorio Chejfec

Research output: Contribution to journalArticle

1497 Scopus citations


Background and Methods. The role of colonoscopy in screening for colorectal cancer is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence and location of advanced colonic neoplasms and the risk of advanced proximal neoplasia in asymptomatic patients (age range, 50 to 75 years) with or without distal neoplasia. Advanced colonic neoplasia was defined as an adenoma that was 10 mm or more in diameter, a villous adenoma, an adenoma with high-grade dysplasia, or invasive cancer. In patients with more than one neoplastic lesion, classification was based on the most advanced lesion. Results. Of 17,732 patients screened for enrollment, 3196 were enrolled; 3121 of the enrolled patients (97.7 percent) underwent complete examination of the colon. The mean age of the patients was 62.9 years, and 96.8 percent were men. Colonoscopic examination showed one or more neoplastic lesions in 37.5 percent of the patients, an adenoma with a diameter of at least 10 mm or a villous adenoma in 7.9 percent, an adenoma with high-grade dysplasia in 1.6 percent, and invasive cancer in 1.0 percent. Of the 1765 patients with no polyps in the portion of the colon that was distal to the splenic flexure, 48 (2.7 percent) had advanced proximal neoplasms. Patients with large adenomas (≥10 mm) or small adenomas (

Original languageEnglish (US)
Pages (from-to)162-168
Number of pages7
JournalNew England Journal of Medicine
Issue number3
Publication statusPublished - Jul 20 2000


ASJC Scopus subject areas

  • Medicine(all)

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