Prevalence and Characteristics of Colorectal Polyps in Symptomatic and Asymptomatic Iranian Patients Undergoing Colonoscopy from 2009-2013

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±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.

What are the Endoscopic and Pathological Characteristics of Colorectal Polyps?

“…Non-neoplastic polyps are classified into the groups of inflammatory, hyperplastic and hamartomatous while neoplastic polyps are classified as tubular, tubulovillous and villous adenoma (Karaman et al, 2013;Shussman and Wexner, 2014). Adenomas contain dysplasia irrespective of the size and need to be monitored (Winawer et al, 2006;Iravani et al, 2014). In this trial, we assessed the prevalence, the location and the histopathology results of the polyps detected during colonoscopy performed upon presentation with various complaints.…”

Clinicopathologic Features of Colorectal Polyps in Shahid Beheshti University of Medical Sciences (SBMU)

“…In other Iranian reviews, 40% to 87% of polyps are located in the left colon prevailing from less than 5% to 60% (includes transverse lesions) in the right colon (Eshghi et al, 2011;Mirzaie et al, 2016;Mirzaie et al, 2012;Iravani et al, 2014;Delavari et al, 2014;Hajmanoochehri et al, 2014;Geramizadeh and Keshtkar-Jahromi, 2013). In most published data transverse colon lesions are not separated, but when considered independently, this compromises 1-15% of all colon polyps (Zhou et al, 2017;Eshghi et al, 2011;Iravani et al, 2014). There are different findings in the different part of the world; some found more adenomas in the right colon (Movafagh et al, 1996;Qumseya et al, 2012) while some detected more in the left colon (Solakoğlu et al, 2014) In our study, most polyps had diminutive size below 5 mm, with tubular histology in the left side of colon, which is compatible with previous results (Silva et al, 2014;Sousa Andrade et al, 2008).…”

“…It seems that in some of the mentioned studies in Iran, due to over-diagnosis of non-neoplastic polyps under Most polyps, including adenomas, located in the left colon, especially rectosigmoid. In other Iranian reviews, 40% to 87% of polyps are located in the left colon prevailing from less than 5% to 60% (includes transverse lesions) in the right colon (Eshghi et al, 2011;Mirzaie et al, 2016;Mirzaie et al, 2012;Iravani et al, 2014;Delavari et al, 2014;Hajmanoochehri et al, 2014;Geramizadeh and Keshtkar-Jahromi, 2013). In most published data transverse colon lesions are not separated, but when considered independently, this compromises 1-15% of all colon polyps (Zhou et al, 2017;Eshghi et al, 2011;Iravani et al, 2014).…”

“…Studies have been showed that approximately two-third of patients had solitary polyps, and advanced age is associated with detecting larger polyps (Lowenfels et al, 2011;Silva et al, 2014;Solakoğlu et al, 2014) Of the 1,106 polyps, adenomatous polyps were the most prevalent types, followed by mucosal tags/polyps, hyperplastic and serrated polyps, inflammatory polyps, hamartomatous, and malignant lesions. Frequency of adenomatous polyps in selected Iranian studies ranged between 61% and 90% (Mirzaie et al, 2012;Darvish et al, 2013;Iravani et al, 2014;Delavari et al, 2014;Hajmanoochehri et al, 2014;Geramizadeh and Keshtkar-Jahromi, 2013), and in some other countries varies between 41% and 61% (Zhou et al, 2017;Kefeli et al, 2014;Wickramasinghe et al, 2014;Valarini et al, 2011). It seems that in some of the mentioned studies in Iran, due to over-diagnosis of non-neoplastic polyps under Most polyps, including adenomas, located in the left colon, especially rectosigmoid.…”

The pathological behaviors and prognostic factors of Chinese and Japanese colorectal cancers from general hospitals: a comparative study of the inpatients with surgical operation

“…The incidence of CRC has been estimated to be 30–50 cases (per 100, 000) in northern America and Europe, and 3–7 cases (per 100, 000) in most Middle East countries [3]. Although epidemiological data show a marked variability around the world, and almost 60% of cases occur in developed countries, its overall incidence rate shows a slow but steady decrease (about 2% per year) [4].…”