Li Xiang1,2, Qiang Zhan3, Xian-Fei Wang4, Xin-Hua Zhao5, Yong-Bai Zhou6, Sheng-Li An7, Ze-Long Han1, Ya-Dong Wang1, Yang-Zhi Xu1, Ai-Min Li1, Ya-Li Zhang1, Si-De Liu1. 1. a Department of Gastroenterology , Nanfang Hospital, Southern Medical University , Guangzhou , China. 2. b Department of Gastroenterology , Longgang district People's Hospital , Shenzhen , Guangdong Province , China. 3. c Department of Gastroenterology , Wuxi City People's Hospital Affiliated to Nanjing Medical University , Wuxi , China. 4. d Department of Gastroenterology , Affiliated Hospital of North Sichuan Medical College , Nanchong , China. 5. e Department of Gastroenterology , Mianyang Central Hospital , Mianyang , China. 6. f Department of Gastroenterology , Longgang Central Hospital , Shenzhen , China. 7. g Department of Biostatistics , School of Public Health and Tropical Medicine, Southern Medical University , Guangzhou , China.
Abstract
OBJECTIVES: Flat colorectal adenomas have a high risk of malignancy; however, their detection is often difficult due to their flat morphology. In this retrospective, large-scale study, we investigated the prevalence and characteristics of flat adenomas in a population in China. METHODS: We analyzed the data collected for 16951 consecutive patients who underwent colonoscopy at four participating hospitals between September 2013 and September 2015. All colonoscopies were performed without magnification. RESULTS: Among the 1,6951 patients, 2938 (17.3%) had adenoma and 796 (4.7%) had flat adenomas. The detection of flat adenoma showed a weak correlation with the detection of adenoma (r = 0.666). Multivariable logistic regression analysis revealed the following independent factors influencing the detection of flat adenomas: patient-related factors of age, presence of warning symptoms, history of adenomas and bowel preparation as well as endoscopist-related factors of endoscopist's level of proficiency, number of colonoscopy operators and withdrawal time. CONCLUSIONS: The prevalence of flat adenomas in our study on Chinese patients was consistent with that reported from other countries. Factors conducive to the detection of flat adenomas were patient age of > 60 years, warning symptoms, history of adenoma, good bowel preparation, experienced endoscopist, single-operator colonoscopy and colonoscopy withdrawal time of >6 min.
OBJECTIVES: Flat colorectal adenomas have a high risk of malignancy; however, their detection is often difficult due to their flat morphology. In this retrospective, large-scale study, we investigated the prevalence and characteristics of flat adenomas in a population in China. METHODS: We analyzed the data collected for 16951 consecutive patients who underwent colonoscopy at four participating hospitals between September 2013 and September 2015. All colonoscopies were performed without magnification. RESULTS: Among the 1,6951 patients, 2938 (17.3%) had adenoma and 796 (4.7%) had flat adenomas. The detection of flat adenoma showed a weak correlation with the detection of adenoma (r = 0.666). Multivariable logistic regression analysis revealed the following independent factors influencing the detection of flat adenomas: patient-related factors of age, presence of warning symptoms, history of adenomas and bowel preparation as well as endoscopist-related factors of endoscopist's level of proficiency, number of colonoscopy operators and withdrawal time. CONCLUSIONS: The prevalence of flat adenomas in our study on Chinese patients was consistent with that reported from other countries. Factors conducive to the detection of flat adenomas were patient age of > 60 years, warning symptoms, history of adenoma, good bowel preparation, experienced endoscopist, single-operator colonoscopy and colonoscopy withdrawal time of >6 min.
Entities:
Keywords:
Colonoscopy; colorectal cancer screening; flat adenoma; risk factor
Authors: Mineo Iwatate; Daizen Hirata; Carlos Paolo D Francisco; Jonard Tan Co; Jeong-Sik Byeon; Neeraj Joshi; Rupa Banerjee; Duc Trong Quach; Than Than Aye; Han-Mo Chiu; Louis H S Lau; Siew C Ng; Tiing Leong Ang; Supakij Khomvilai; Xiao-Bo Li; Shiaw-Hooi Ho; Wataru Sano; Santa Hattori; Mikio Fujita; Yoshitaka Murakami; Masaaki Shimatani; Yuzo Kodama; Yasushi Sano Journal: Dig Endosc Date: 2022-03-14 Impact factor: 6.337