Department of Gastroenterology, Dongyang Hospital affiliated to Wenzhou Medical University, Dongyang, China.
Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Cancer Control. 2023 Jan-Dec;30:10732748231193243. doi: 10.1177/10732748231193243.
Although colonoscopy is considered the most effective tool for reducing colorectal cancer-related morbidity, the age at which average-risk individuals begin colonoscopic screening is undetermined. This study aimed to compare the adenoma and advanced adenoma detection rates according to age and sex in a large average-risk population in the rural areas of Eastern China.
This observational, single-center, retrospective study included patients with average colorectal cancer risk and examined the adenoma and advanced adenoma detection rates using age intervals of 5 years. We also compared the size and age of patients with and without advanced adenoma.
We included 18 928 patients with a median age of 54 years (range 15-90 years), including 10 143 men and 8785 women. The adenoma and advanced adenoma detection rates were 17.08% and 5.24%, respectively, and increased with age in the whole population. The adenoma detection rates increased from 8.97% (aged 40-44) to 14.98% (aged 45-49) and 6.24% (aged 45-49) to 11.00% (aged 50-54) in men and women (both < .001), respectively. The advanced adenoma detection rates increased from 2.19% (aged 40-44) to 4.76% (aged 45-49) and 1.89% (aged 45-49) to 3.13% (aged 50-54) in men ( = .002) and women ( = .056), respectively. Patients with advanced adenomas were significantly older than those with non-advanced adenomas ( < .001). The tumors in the advanced adenoma group were significantly larger than those in the non-advanced adenoma group ( < .001).
The adenoma and advanced adenoma detection rates increased significantly in average-risk population aged 45 years and older, especially in men.
虽然结肠镜检查被认为是降低结直肠癌相关发病率最有效的工具，但平均风险人群开始结肠镜筛查的年龄尚未确定。本研究旨在比较中国东部农村地区一个大型平均风险人群中按年龄和性别划分的腺瘤和高级别腺瘤检出率。
这是一项观察性、单中心、回顾性研究，纳入了具有平均结直肠癌风险的患者，并按 5 年的年龄间隔检查了腺瘤和高级别腺瘤的检出率。我们还比较了有和无高级别腺瘤患者的肿瘤大小和年龄。
我们纳入了 18928 名中位年龄为 54 岁（范围 15-90 岁）的患者，其中 10143 名为男性，8785 名为女性。腺瘤和高级别腺瘤的检出率分别为 17.08%和 5.24%，且在全人群中随年龄增长而增加。男性和女性的腺瘤检出率分别从 8.97%（40-44 岁）增加到 14.98%（45-49 岁）和 6.24%（45-49 岁）增加到 11.00%（50-54 岁）（均<0.001），高级别腺瘤检出率分别从 2.19%（40-44 岁）增加到 4.76%（45-49 岁）和 1.89%（45-49 岁）增加到 3.13%（50-54 岁）（男性：<0.001；女性：=0.056）。高级别腺瘤患者明显比非高级别腺瘤患者年龄大（<0.001）。高级别腺瘤组的肿瘤明显大于非高级别腺瘤组（<0.001）。
45 岁及以上的平均风险人群中，腺瘤和高级别腺瘤的检出率显著增加，尤其是男性。
