Xu Han1, Wei Qian1, Yu Liu1, Ting Zheng2, Xiaoju Su1,3, Pingping Zhang1,3, Yan Chen1,3, Lianghao Hu1,3, Zhaoshen Li1,3. 1. Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China. 2. University of Michigan, University of Michigan Hospitals, Ann Arbor, Michigan, USA. 3. Digestive Endoscopy Center, Changhai Hospital, the Second Military Medical University, Shanghai, China.
Abstract
AIM: The lack of risk profile data regarding changes in multiple polyps identified by colonoscopy constrains the creation of evidence-based guidelines. This retrospective case-control study addresses this issue by characterizing the relationship between size, location and histology of multiple polyps, in addition to population-associated features in a large teaching hospital-based Chinese population. METHODS: A large, case-control retrospective analysis was conducted on polyps obtained from 8308 patients who presented at the Digestive Endoscopy Center, Changhai Hospital, Shanghai, China from January 2013 to August 2015. A total of 10 572 polyps were analyzed, with risk factors extrapolated through chart review of patient electronic medical records. RESULTS: Single polyps were identified in 6843 patients (82.4%) while multiple polyps were found in 1465 (17.6%). Multivariate analysis indicated that males were more likely to have multiple polyps (p < 0.001). Compared with patients with single polyps, the numbers of those with multiple polyps increased significantly as age increased (p < 0.001). Small (6-9 mm) non-advanced adenomas were more likely to be found as multiple adenomas than were diminutive (<5 mm) non-advanced adenomas (p < 0.000). While the majority of the advanced and non-advanced adenomas were diagnosed in patients with single adenomas (56.0% and 65.4%, respectively), the advanced adenomas were more likely to be in multiples compared with non-advanced adenomas (p < 0.001). CONCLUSIONS: Our data indicate that particular features of colorectal polyps such as their large size, advanced histology and patient demographics including gender and age are risk factors associated with multiple polyps during diagnosis, screening and surveillance. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
AIM: The lack of risk profile data regarding changes in multiple polyps identified by colonoscopy constrains the creation of evidence-based guidelines. This retrospective case-control study addresses this issue by characterizing the relationship between size, location and histology of multiple polyps, in addition to population-associated features in a large teaching hospital-based Chinese population. METHODS: A large, case-control retrospective analysis was conducted on polyps obtained from 8308 patients who presented at the Digestive Endoscopy Center, Changhai Hospital, Shanghai, China from January 2013 to August 2015. A total of 10 572 polyps were analyzed, with risk factors extrapolated through chart review of patient electronic medical records. RESULTS:Single polyps were identified in 6843 patients (82.4%) while multiple polyps were found in 1465 (17.6%). Multivariate analysis indicated that males were more likely to have multiple polyps (p < 0.001). Compared with patients with single polyps, the numbers of those with multiple polyps increased significantly as age increased (p < 0.001). Small (6-9 mm) non-advanced adenomas were more likely to be found as multiple adenomas than were diminutive (<5 mm) non-advanced adenomas (p < 0.000). While the majority of the advanced and non-advanced adenomas were diagnosed in patients with single adenomas (56.0% and 65.4%, respectively), the advanced adenomas were more likely to be in multiples compared with non-advanced adenomas (p < 0.001). CONCLUSIONS: Our data indicate that particular features of colorectal polyps such as their large size, advanced histology and patient demographics including gender and age are risk factors associated with multiple polyps during diagnosis, screening and surveillance. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.