ABSTRACT
Early diagnosis and endoscopic resection of adenomatous polyps is the main approach for screening and prevention of colorectal cancer [CRC]. We aimed to assess polyp detection rate [PDR] and to characterize demographic, clinical, and pathological features of colorectal polyps in an Iranian population. We retrospectively analyzed the data from 5427 colonoscopies performed during 2007-2012 at Masoud Clinic, the main endoscopy center associated with Sasan Alborz Biomedical Research Center, in Tehran, Iran. Our sample included 2928 [54%] women and 2499 [46%] men, with the mean age of 48.3 years [SD=16.1]. The most common reasons for colonoscopy included screening in 25.0%, and gastrointestinal bleeding in 15.2%. Cecal intubation was successful in 86% of patients. The quality of bowel preparation was fair to excellent in 78.1% [n=4235] of colonoscopies. Overall PDR was 42.0% [95% CI: 40.6-43.3]. The PDR in men [51.1%, 95% CI: 49.1-53.1] was significantly higher than women [34.2%, 95% CI: 32.4-35.9, p<0.001]. Polyps were more frequently observed in patients after the 6th decade of life [F=3.2; p=0.004]. CRC was detected in 2.9% [73/2499] of men and 1.9% [57/2928] of women [p=0.02]. The mean age for patients with cancer was significantly higher than that for individuals with polyps, 60.9 [SD=13.4] year vs. 56.9 [SD=13.7] year, respectively [p=0.001]. Almost 82.8% of the lesions were precancerous with tubular type predominance [62.3%] followed by tubulo-villous [10.3%], villous [6.6%], and serrated [3.6%]. Hyperplastic/inflammatory polyps comprised 17.2% of lesions. Distal colon was more prone to develop polyps and cancer than proximal colon in our series. These findings provide a great infrastructure for next preventive programs and have implications for colorectal cancer screening at population-level