Four hundred and fifty-six distal polyps were detected in 160 (53%) of 300 patients over 45 years of age examined by routine proctosigmoidoscopy after July 1, 1965. Sixty-five percent of these lesions were multiple, 97% were 5 mm or less in size, and 75% were located in the middle third segment of the rectocolon visualized. Sixteen proximal polyps were revealed in 8 (3.8%) of 211 patients examined by roentgenogram of the colon. Half of these lesions were less than 1 cm in size. Higher up polyps were roentgenologically demonstrated in patients with distal polyps almost twice as frequently as in those with normal results of endoscopy. A significantly higher incidence of both distal and proximal polyps was found in cigarette smokers and ex-smokers as compared with nonsmokers. Selecting smokers rather than those with distal polyps for subsequent proctologic procedures should efficiently increase the yield of benign adenomatous polyps, at half the cost of similar studies in an unselected population.
Drexler J. Asymptomatic Polyps of the Colon and Rectum: III. Proximal and Distal Polyp Relationships. Arch Intern Med. 1971;127(3):466–469. doi:10.1001/archinte.1971.00310150126017
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