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Colorectal adenomas more common among men, older patients
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The prevalence of colorectal adenoma detection during colonoscopy was greater among men and older patients, according to recent results.
In a retrospective cohort study, researchers evaluated data on adenoma detection in 20,792 participants aged 50 years or older who underwent screening colonoscopy from 2006 to 2008. The procedures were performed by 102 physicians, and all participants were members of Kaiser Permanente Northern California.
The mean adenoma detection rate was 24.1 patients with one or more adenomas for every 100 screened (range 6.6-48.1). One or more adenomatous polyps and colorectal cancer were detected in 24.6% and 1.5% of patients, respectively.
Adenoma detection was more prevalent in patients of advanced age and peaked among those aged 70 to 74 years (OR=2.00; 95% CI, 1.76-2.26 vs. those aged 50 to 54 years). This increase was particularly significant among the same age group for proximal adenomas (OR=2.39; 95% CI, 2.05-2.80), while an OR of 1.89 (95% CI, 1.63-2.19) was determined for distal adenomas.
At all ages and across all evaluated racial/ethnic groups, adenomas were more common among men (30.6%) than women (20.2%; OR=1.77; 95% CI, 1.66-1.89). Overall adenoma prevalence increased from 25% of cases screened at aged 50 to 54 years to 39% of those screened at 70 to 74 years among men, compared with an increase from 15% at 50 to 54 years to 26% at 70 to 74 years among women (P<.001 for both trends).
Overall adenoma prevalence was similar between whites and all other evaluated racial/ethnic groups. Blacks were more likely than whites to have proximal adenomas (OR=1.26; 95% CI, 1.04-1.54); risk for distal adenomas was similar between the two races (OR=1.09; 95% CI, 0.90-1.33).
“Adenoma prevalence varies by age and sex,” researcher Douglas A. Corley, MD, gastroenterologist at Kaiser Permanente in San Francisco, told Healio.com. “If we use adenoma detection rate as a measure of physician quality for colonoscopy, we may need to take into account the physician’s patient population to make fair comparisons. Two physicians who are equal, but who take care of different patient populations, may have very different adenoma detection rates.”
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