Nuttapoom Sermsri, MD, Siripong Sirikurnpiboon, MD. Rajavithi Hospital
Background: Increasing morbidity and mortality from colorectal cancer is evident in recent year in the developing Asian nations. Result of screening colonoscopy from Western countries reported adenoma detection rate (ADRs) of 30-40% while those from Asia has ADR as low as 10%. There have been limited data regarding screening colonoscopy in Thailand. The objectives of this study were to determine polyp detection rate in Thai people, to evaluate the incidence of colorectal cancer detected during screening colonoscopy, and to determine the endoscopic finding of the polyps which might have some impacted on endoscopist to performed polypectomy.
Materials and methods: This study was retrospective electronic chart review of asymptomatic Thai adults who underwent screening colonoscopy in our endoscopic center from September 2012 to July 2016. Biopsy and surgery was performed depending on the identified lesions.
Result: A total of 630 cases were reviewed. The average age of patient was 59.0 ± 12.2 years (range 15-87) and 60.2% were female. Most of the cases (58.3%) has no lower gastrointestinal tract symptoms and 95.3% of cases had achievement of total colonoscopy. About 44.4% (280 cases) of all colonoscopy had abnormal colonoscopic finding, and of these, 200 patients (31.7%) were reported to have colonic polyps or tumor. High risk adenomatous (villous or tubulovillous or high grade dysplasia) were found in 9 cases (1.4%), low risk adenoma in 71 cases (11.3%) and hyperplastic polyp in 22 cases (3.5%). Seventeen cases (2.7%) had colorectal cancer and 88.2% of them were non-metastatic including two stage 1 cases, seven stage 2 cases and four stage 3 cases. Only two cases had metastasis. The most common cancer site was left-sided colon including rectum (76.4%).
Conclusions: High prevalence of colorectal cancer and high risk adenoma were found in the Thai population age 49-74 years old by screening colonoscopy and more dominant in female. The overall polyp and tumor detection rate was 31.7%, low risk adenoma detection rate was 11.3%, high risk adenoma detection rate was 1.4% and colorectal carcinoma detection rate was 2.7%. Integration of screening colonoscopy into the national cancer screening program should be implemented to detect early cases of advanced colorectal neoplasia and improved survival of colorectal cancer patients in Thailand. Therefore, new technology would play an important role indistinguishing polyps.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79995
Program Number: P192
Presentation Session: Poster (Non CME)
Presentation Type: Poster
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