BACKGROUND AND STUDY AIMS: @entity1 who have had a @entity2513 are likely to develop a @entity652 , and therefore need to be kept under surveillance. The question is whether @entity652 will be found at the same anatomical site as the preceding @entity652 , thus prompting us to focus surveillance examinations on this region, using flexible sigmoidoscopy or total colonoscopy. @entity1 AND METHODS: Between 1978 and 1996 a long-term follow up of 1091 @entity1 was prospectively documented at the Erlangen Registry of @entity1127 . The anatomical sites--distal (rectosigmoid) and proximal colon--of two subsequent generations of @entity652 were analysed using logistic regression analysis. RESULTS: In 556 (51%) @entity1 @entity652 were found during follow up. In 211 (37.9%) of these @entity1 a right-sided shift in the first generation of @entity652 in comparison with initial lesions (P<0.0001) was found. Some 305 @entity1 underwent further follow up, and 51 (27.1%) out of 188 @entity1 with metachronous lesions demonstrated a right-sided shift in their second generation (vs. first generation) of @entity652 . Proximally located first generation @entity652 would be missed by flexible sigmoidoscopy in 50.8% of @entity1 with only distal @entity652 at baseline colonoscopy, and in 58.7% of @entity1 with second-generation lesions. Multivariate analysis revealed that multiplicity (odds ratio 2.64, 95% CI 1.49-4.66) and size of initial @entity652 (>5 mm) (odds ratio 3.60, 95% CI 1.96-6.66) were significantly associated with a right-sided shift in @entity652 , while female gender was associated with a significantly lower tendency to manifest a right-sided shift (odds ratio of 0.64. 95% CI 0.43-0.94). CONCLUSIONS: @entity652 are found significantly more often in the right colon than would be expected assuming clustering at the same anatomical site as the preceding lesions. Total colonoscopy is thus needed for surveillance, regardless of the initial @entity652 site.

Right-sided shift found in metachronous XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity652 :: ('MESH:D000236', 'Disease') :: ['metachronous adenomas', 'metachronous adenoma', 'Metachronous adenomas', 'adenomas', 'adenoma'] @entity2513 :: ('MESH:C563365', 'Disease') :: ['colorectal adenoma'] @entity1127 :: ('MESH:D011127', 'Disease') :: ['Colorectal Polyps']
@entity2513 :: (MESH:C563365,Disease) :: ['colorectal adenomas']
