Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Prevalence and Characteristics of Colorectal Polyps in Symptomatic and Asymptomatic Iranian Patients Undergoing Colonoscopy from 2009-2013

  • Published : 2014.12.18
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Abstract

Background: Colorectal cancer is the third most common type of cancer in males and the second in females in Iran. Males are more likely to develop CRC than women and age is considered as a main risk factor for colorectal cancer. Prevalence of colorectal cancer has been increasing in Asian countries. Aim: The object of this study was to determine the clinical and pathology characteristics of colorectal polyps in Iranian patients and to investigate the variation between our populations with other populations. Materials and Methods: A total of 167 patients with colorectal polyps were included in our study. All underwent colonoscopy during 2009-2013 and specimens were taken through polypectomy and transferred to pathology. All data in patient files including pathology reports were collected and analyzed by SPSS 16 software. A two-tailed test was used and a P-value of < 0.05 was considered significant. Results: Mean age of participants was $57{\pm}15$. Some 84 were females (50.3%) and 83 males (49.7%). Total of 225 polyps were detected which 119 (52.9%) were in males and 106 (47.1%) were in females. Solitary polyps were observed in 124 patients (74%), 26 (15.6%) had two polyps and 17 (10.1%) with more than two polyps (three to five). Rectosigmoid was the site of most of the polyps (63.1%), followed by 19.6% in the descending colon, 7.6% in the transverse, 5.8% in the ascending, and 3.1% in the cecum, data being missing in two cases. Conclusions: Recto sigmoid was site of most of the polyps. The most prevalent type of lesion was adenomatous polyps detected in 78 (34.7%). Mixed hyperplastic adenomatous type observed in 70 (31.1%). This high prevalence of adenomatous polyps in Iranian patients implies the urgent need for screening plans to prevent further healthcare problems with colorectal cancer in the Iranian population.

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References

  1. Almendingen K, Hofstad B, Vatn MH (2003). Does a family history of cancer increase the risk of occurrence, growth, and recurrence of colorectal adenomas? Gut, 52, 747-51. https://doi.org/10.1136/gut.52.5.747
  2. Anderson JC, Latreille M, Messina C, et al (2009). Smokers as a high-risk group: data from a screening population. J Clin Gastroenterol, 43, 747-52. https://doi.org/10.1097/MCG.0b013e3181956f33
  3. Bafandeh Y, Daghestani D, Esmaili H (2005). Demographic and anatomical survey of colorectal polyps in an Iranian population. Asian Pac J Cancer Prev, 6, 537-40.
  4. Bafandeh Y, Khoshbaten M, Eftekhar Sadat AT, et al (2008). Clinical predictors of colorectal polyps and carcinoma in a low prevalence region: results of a colonoscopy based study. World J Gastroenterol, 14, 1534-8. https://doi.org/10.3748/wjg.14.1534
  5. Botteri E, Iodice S, Raimondi S, et al (2008). Cigarette smoking and adenomatous polyps: a meta-analysis. Gastroenterology, 134, 388-95. https://doi.org/10.1053/j.gastro.2007.11.007
  6. Burnett-Hartman AN, Newcomb PA, Mandelson MT, et al (2011). Colorectal polyp type and the association with charred meat consumption, smoking, and microsomal epoxide hydrolase polymorphisms. Nutr Cancer, 63, 583-92. https://doi.org/10.1080/01635581.2011.553021
  7. Burnett-Hartman AN, Newcomb PA, Phipps AI, et al (2012). Colorectal endoscopy, advanced adenomas, and sessile serrated polyps: implications for proximal colon cancer. Am J Gastroenterol, 107, 1213-9. https://doi.org/10.1038/ajg.2012.167
  8. Chen Y-S, Xu S-X, Ding Y-B, et al (2013). Colorectal cancer screening in high-risk populations: a survey of cognition among medical professionals in Jiangsu, China. Asian Pac J Cancer Prev, 14, 6487-91. https://doi.org/10.7314/APJCP.2013.14.11.6487
  9. Diamond SJ, Enestvedt BK, Jiang Z, et al (2011). Adenoma detection rate increases with each decade of life after 50 years of age. Gastrointest Endosc, 74, 135-40. https://doi.org/10.1016/j.gie.2011.03.1178
  10. East JE, Saunders BP, Jass JR (2008). Sporadic and syndromic hyperplastic polyps and serrated adenomas of the colon: classification, molecular genetics, natural history, and clinical management. Gastroenterol Clin North Am, 37, 25-46. https://doi.org/10.1016/j.gtc.2007.12.014
  11. Hodadoostan MK, Fatemi R, Maserat E, et al (2010). Clinical & pathology characteristics of colorectal polyps in iranian population. Asian Pac J Cancer Prev, 11, 557-60.
  12. Howlader N, Ries LA, Mariotto AB, et al (2010). Improved estimates of cancer-specific survival rates from populationbased data. J Nat Cancer Inst, 102, 1584-98. https://doi.org/10.1093/jnci/djq366
  13. Karagianni V, Merikas E, Georgopoulos F, et al (2010). Risk factors for colorectal polyps: findings from a Greek casecontrol study. Revista Medico-Chirurgicala a Societatii de Medici si Naturalisti din Iasi, 114, 662.
  14. Karaman H, Karaman A, Erden A, et al (2013). Relationship between colonic polyp type and the neutrophil/lymphocyte ratio as a biomarker. Asian Pac J Cancer Prev, 14, 3159-61. https://doi.org/10.7314/APJCP.2013.14.5.3159
  15. Kastuar S, Narayanan S, Kastuar S, et al (2011). Prevalence of colon polyps in asymptomatic indians undergoing screening colonoscopy in the USA. Practical Gastroenterology, 41.
  16. Kilickap S, Arslan C, Rama D, et al (2012). Screening colonoscopy participation in Turkish colorectal cancer patients and their first degree relatives. Asian Pac J Cancer Prev, 13, 2829Y32. https://doi.org/10.7314/APJCP.2012.13.6.2829
  17. Levin B, Lieberman DA, McFarland B, et al (2008). Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American cancer society, the US multi-society task force on colorectal cancer, and the American college of radiology. Gastroenterology, 134, 1570-95. https://doi.org/10.1053/j.gastro.2008.02.002
  18. Lowenfels AB, Williams JL, Holub JL, et al (2011). Determinants of polyp size in patients undergoing screening colonoscopy. BMC Gastroenterol, 11, 101. https://doi.org/10.1186/1471-230X-11-101
  19. Luigiano C, Ferrara F, Ghersi S, et al (2010). Endoclip-assisted resection of large pedunculated colorectal polyps: technical aspects and outcome. Dig Dis Sci, 55, 1726-31. https://doi.org/10.1007/s10620-009-0905-2
  20. Mirzaie AZ, Abolhasani M, Moghaddam RM, et al (2012). The frequency of gastrointestinal polyps in Iranian population. Iranian J Pathol, 7, 183-9.
  21. Mosli MH, Al-Ahwal MS (2012). Does the increasing trend of colorectal cancer incidence in jeddah reflect a rise in the Kingdom of Saudi Arabia? Asian Pac J Cancer Prev, 13, 6285-8. https://doi.org/10.7314/APJCP.2012.13.12.6285
  22. Mulcahy H, O'Donoghue D (1997). Duration of colorectal cancer symptoms and survival: the effect of confounding clinical and pathological variables. Eur J Cancer, 33, 1461-7. https://doi.org/10.1016/S0959-8049(97)00089-0
  23. Murphy G, Devesa SS, Cross AJ, et al (2011). Sex disparities in colorectal cancer incidence by anatomic subsite, race and age. Int J Cancer, 128, 1668-75. https://doi.org/10.1002/ijc.25481
  24. Muto T, Bussey HJ, Morson BC (1975). The evolution of cancer of the colon and rectum. Cancer, 36, 2251-70. https://doi.org/10.1002/cncr.2820360944
  25. Neri E, Faggioni L, Cini L, et al (2011). Colonic polyps: inheritance, susceptibility, risk evaluation, and diagnostic management. Cancer Management Res, 3, 17.
  26. Ng SC, Wong SH (2013). Colorectal cancer screening in Asia. Br Med Bull, 105, 29-42. https://doi.org/10.1093/bmb/lds040
  27. Norrelund N, Norrelund H (1996). Colorectal cancer and polyps in patients aged 40 years and over who consult a GP with rectal bleeding. Family Practice, 13, 160-5. https://doi.org/10.1093/fampra/13.2.160
  28. O'Brien MJ, Winawer SJ, Zauber AG, et al (1990). The National Polyp Study. Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterology, 98, 371-9.
  29. O'Brien MJ, Yang S, Mack C, et al (2006). Comparison of microsatellite instability, CpG island methylation phenotype, BRAF and KRAS status in serrated polyps and traditional adenomas indicates separate pathways to distinct colorectal carcinoma end points. Am J Surg Pathol, 30, 1491-501. https://doi.org/10.1097/01.pas.0000213313.36306.85
  30. Onega T, Goodrich M, Dietrich A, et al (2010). The influence of smoking, gender, and family history on colorectal adenomas. J Cancer Epidemiol, 2010, 509347.
  31. Patel BB, Yu Y, Du J, et al (2009). Age-related increase in colorectal cancer stem cells in macroscopically normal mucosa of patients with adenomas: a risk factor for colon cancer. Biochem Biophys Res Commun, 378, 344-7. https://doi.org/10.1016/j.bbrc.2008.10.179
  32. Roslani AC, Abdullah T, Arumugam K (2012). Screening for colorectal neoplasias with fecal occult blood tests: falsepositive impact of non-dietary restriction. Asian Pac J Cancer Prev, 13, 237-41. https://doi.org/10.7314/APJCP.2012.13.1.237
  33. Safaee A, Fatemi SR, Ashtari S, et al (2012). Four years incidence rate of colorectal cancer in Iran: a survey of national cancer registry data-implications for screening. Asian Pac J Cancer Prev, 13, 2695-8. https://doi.org/10.7314/APJCP.2012.13.6.2695
  34. Shemirani AI, Haghighi MM, Zadeh SM, et al (2011). Simplified MSI marker panel for diagnosis of colorectal cancer. Asian Pac J Cancer Prev, 12, 2101-4.
  35. Siegel R, DeSantis C, Virgo K, et al (2012). Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin, 62, 220-41. https://doi.org/10.3322/caac.21149
  36. Spring KJ, Zhao ZZ, Karamatic R, et al (2006). High prevalence of sessile serrated adenomas With BRAF mutations: a prospective study of patients undergoing colonoscopy. Gastroenterology, 131, 1400-7. https://doi.org/10.1053/j.gastro.2006.08.038
  37. Winawer SJ, Fletcher RH, Miller L, et al (1997). Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology, 112, 594-642. https://doi.org/10.1053/gast.1997.v112.agast970594
  38. Zois CD, Christodoulou DK, Katsanos KH, et al (2011). Endoscopic resection and histological evaluation of colorectal polyps: Is it a definitive treatment? An Gastroenterology, 24, 115-20.

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