Analysis of clinicopathological characteristics and changing trend of 77 978 cases of colorectal polyps and colorectal cancer detected by colonoscopy in the past 27 years / 中华消化杂志

ABSTRACT

Objective To explore the detection rate of colorectal polyps and colorectal cancer under colonoscopy,and their clinicopathological characteristics and changing trend.Methods From January 1,1991 to December 31,2017,at Guangzhou First People's Hospital,the colorectal polyps and colorectal cancer diagnosed by colonoscopy were collected.The gender,age,location of colorectal polyps and colorectal cancer and pathological type were retrospectively analyzed.Chi-square test was performed for statistical analysis.Results Among 77 978 patients underwent routine colonoscope examination,male and female accounted for 50.18％ (39 132/77 978) and 49.82％ (38 846/77 978),respectively;and the age was (52.8 ± 15.7)years.A total of 23 240 patients with colorectal polyps were detected,and the total detection rate was 29.80％.The detection rate of colorectal polyps of male patients was higher than that of female patients (35.11％,13 741/39 132 vs.24.45％,9 499/38 846),and the difference was statistically significant (x2 =1 059.16,P ＜0.01),the age was (59.2 ± 14.6) years.The most common location of polyps was left colon,accounted for 48.56％ (11 286/23 240).The pathological type was adenoma (60.99％,13 726/22 504).Totally 5 204 patients with colorectal cancer were detected,the detection rate of 6.67％;the detection rate of male was higher than that of female (7.71％,3 018/39 132 vs.5.63％,2 186/38 846),and the difference was statistically significant (x2 =136.07,P ＜0.01),the age was (63.5 ± 12.5) years.The colorectal cancer was predominantly located in the left colon (73.71％,3 836/5 204).And the common pathological type was moderately differentiated adenocarcinoma (83.61％,4 351/5 204).Based on a nine-year as a time period,the detection rate of eolorectal polyps was 12.91％ (599/4 639) from 1991 to 1999,22.74％ (3 784/16 642) from 2000 to 2008,and 33.26％ (18 857/56 697) from 2009 to 2017,showing a significant upward trend (x2 =1 353.45,P ＜0.01).The detection rate of colorectal cancer was 9.03％ (419/4 639) from 1991 to 1999,8.59％ (1 430/ 16 642) from 2000 to 2008,and 5.92％ (3 355/56 697) from 2009 to 2017,showing a significant downward trend (x2 =191.89,P ＜ 0.01).There was no significant change in pathological types of colorectal polyps in 27 years (x2 =201.08,P ＞ 0.05);while moderately differentiated adenocarcinoma increased,however,the highly and poorly differentiated type decreased (x2 =249.27,P ＜ 0.01).No significant changes in lesion location was found (x2 =117.11 and 134.82,both P ＞ 0.05).Conclusions The detection rate of colorectal polyps increased in the past 27 years,while colorectal cancer decreased.The elderly men are susceptible populations.The most common location of colorectal polyps and cancer are left colon,which should be carefully examined during colonoscope examination.