Clinicopathological profile of colorectal polyps: retrospective analysis from tertiary care center in Southern India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20193920Keywords:
Adenomas, Colorectal cancer, Colorectal polyps, DysplasiaAbstract
Background: Colorectal Cancer is the fourth most commonly diagnosed and chronological changes in colorectal polyps and cancer is important in efficacy of screening strategies. In this study, we aimed to compare clinicopathological features of colorectal polyps and also aimed to characterise the distribution and the pathological features of polyps during an 18-year period divided in to two groups.
Methods: This is retrospective analysis of cases that underwent colonoscopy and found to have colorectal polyps were re-viewed retrospectively for 18 year period are retrieved. 18 year period was divided in to 2001 to 2010 and 2011 to 2018.
Results: Among 4230 patients underwent colonoscopy between January 2001 and September 2018, 1356 were excluded; of the remaining 2874, 986 were found to have 1,272 polyps. 306 patients had 412 polyps in 2001 to 2010 group and 680 patients had 860 polyps in 2011 to 2018 group. Adenomas on the left sided colon were significantly higher in the first time period (40.2% vs 30%, p <0.0003). Polyps on the right sided colon were significantly higher in the second time period (37.3% vs 36.9%, p <0.0005). The most common histology in the both periods is tubular adenoma. Histology of adenomas with high grade dysplasia were significantly more in first period (12.4% vs 7.6%, p <0.005).
Conclusions: Our data shows shift in polyps from left side to right side colon in recent years. There was no significant change in shift in advanced adenomas from left side to right side of colon.
References
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86.
Nouraie M, Hosseinkhah F, Brim H, Zamanifekri B, Smoot DT, Ashktorab H. Clinicopathological features of colon polyps from African-Americans. Dig Dis Sci. 2010;55(5):1442-9.
Zauber AG, Winawer SJ, O'Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366(8):687-96.
Brenner H, Haug U, Arndt V, Stegmaier C, Altenhofen L, Hoffmeister M. Low risk of colorectal cancer and advanced adenomas more than 10 years after negative colonoscopy. Gastroenterology. 2010;138(3):870-6.
Visovan II, Tantau M, Ciobanu L, Pascu O, Tantau A. Increasing prevalence of right-sided colonic adenomas in a high-volume endoscopy department in Romania: implications for colorectal cancer screening. J Gastrointestin Liver Dis. 2014;23(2):147-51.
Coode PE, Chan KW, Chan YT. Polyps and diverticula of the large intestine: a necropsy survey in Hong Kong. Gut. 1985;26(10):1045-8.
Tony J, Harish K, Ramachandran TM, Sunilkumar K, Thomas V. Profile of colorectal polyps in southern Indian population. Indian J Gastroenterol. 2007;26(3):127-9.
Greene FL. Distribution of colorectal neoplasms: a left to right shift of polyps and cancer. Am Surg. 1983;49(2):62-5.
Chan AO, Hui WM, Chan CK, Lai KC, Hu WH, Yuen MF, et al. Colonoscopy demand and practice in a regional hospital over 9 years in Hong Kong: resource implication for cancer screening. Digestion 2006;73(2-3):84-8.
Siegel RL, Ward EM, Jemal A. Trends in colorectal cancer incidence rates in the United States by tumor location and stage, 1992-2008. Cancer Epidemiol Biomarkers Prev. 2012;21(3):411-6.
Jain M, Vij M, Srinivas M, Michael T, Venkataraman J. Spectrum of colonic polyps in a South Indian Urbam cohort. J Dig Endosc. 2017;8(3):119-22.
Amarapurkar AD, Nichat P, Narawane N, Amarapurkar D. Frequency of colonic adenomatous polyps in a tertiary hospital in Mumbai. Indian J Gastroenterol. 2016;35(4):299-304.
Atkin WS, Morson BC, Cuzick J. Long-term risk of colorectal cancer afterexcision of rectosigmoid adenomas. N Engl J Med. 1992;326(10):658-62.
Greene FL. Distribution of colorectal neoplasms: a left to right shift of polyps and cancer. Am Surg. 1983;49(2):62-5.
Chan AO, Hui WM, Chan CK, et al. Colonoscopy demand and practice in a regional hospital over 9 years in Hong Kong: resource implication for cancer screening. Digestion. 2006;73(2-3):84-8.
Thorn M, Bergstrom R, Kressner U, Sparen P, Zack M, Ekbom A. Trends in colorectal cancer incidence in Sweden 1959-93 by gender, localization, time period, and birth cohort. Cancer Causes Control. 1998;9(2):145-52.
Kudo S, Hirota S, Nakajima T, Hosobe S, Kusaka H, Kobayashi T, et al. Colorectal tumours and pit pattern. J Clin Pathol. 1994;47(10):880-5
Hoffman A, Sar F, Goetz M, Tresch A, Mudter J, Biesterfeld S, et al. High definition colonoscopy combined with i-Scan is superior in the detection of colorectal neoplasias compared with standard video colonoscopy: A prospective randomized controlled trial. Endoscopy. 2010;42(10):827-33.
Floer M, Meister T. Endoscopic improvement of the adenoma detection rate during colonoscopy - Where do we stand in 2015? Digestion. 2016;93(3):202-13.
