Detection of Colon Polyps in India—A Large Retrospective Cohort Study (DoCPIr)

Abstract

Abstract Objective Colorectal cancer (CRC) is an emerging public health problem in Asia and India. However, there is scarcity of data on CRC and adenoma. We aimed to study prevalence and characteristics of colonic polyps in a large retrospective cohort. Methods For this retrospective single center study, all patients with age > 18 years undergoing colonoscopy from January 2018 to December 2019 were included. Age, gender, and polyp characteristics were collected from endoscopy and histology database. Patients with incomplete histology reports and anal canal polyps were excluded. Based on histology, polyps were divided into adenocarcinoma, adenoma with advanced pathology (AAP; size > 10 mm, villous morphology or high-grade dysplasia), nonadvanced adenomas (nAAP), and nonadenomas. Results Overall colon polyp prevalence was 10.18% (3551/34893). The mean age (standard deviation [SD]) was 51.51 (14.84) with 75.4% males, of which 128 (3.6%) were adenocarcinoma. A total of 1514 (42.64%) were adenomas; 344 (9.7%) were AAP and 1170 (32.9%) were nAAP. The remaining 1909 (53.8%) were nonadenomas. Colonic adenoma prevalence after excluding adenocarcinoma was 4.35% (1514/34893). Adenocarcinoma (68.8% vs. 31.2%), AAP (70.6% vs. 29.4%), other adenomas (75.4% vs. 24.6%), and nonadenomas (76.7% vs. 23.3%) were significantly higher in male compared with female (p < 0.05). Adenomas and adenocarcinomas were more common in left colon and rectum than right colon (p < 0.05). The mean age (SD) were significantly lower in nonadenomas than adenocarcinomas, AAP, and other adenomas (p 0.0001; 49.25 [14.84] vs. 55.97 [12.47], 54.78 [16.40], 53.76 [13.71]). Conclusions The prevalence of colonic adenoma in India is 4.35%. Male gender and increased age were associated with increased risk of colonic adenoma and adenocarcinoma, which is more common in left colon and rectum. Prospective multicenter studies are required for evaluation of other risk factors of CRC and colonic adenomas.