A shift from distal to proximal neoplasia in the colon: a decade of polyps and CRC in Italy

BMC Gastroenterology

Research Article

Alberto Comino¹  Elisabetta Castagna²  Luigi Fenoglio²  Cora Luchino² 

[1] Anatomia Patologica, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy;Medicina Interna, Azienda Ospedaliera S, Croce e Carle, Cuneo, Italy;

关键词: Adenoma;    Hyperplastic Polyp;    Advanced Adenoma;    Serrate Polyp;    Serrate Adenoma;   

DOI  :  10.1186/1471-230X-10-139

 received in 2009-10-20, accepted in 2010-11-25,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIn the last years a trend towards proximalization of colorectal carcinomas (CRC) has been reported. This study aims to evaluate the distribution of CRC and adenomatous polyps (ADP) to establish the presence of proximalization and to assess the potential predictors.MethodsWe retrieved histology reports of colonic specimens excised during colonoscopy, considering the exams performed between 1997 and 2006 at Cuneo Hospital, Italy. We compared the proportion of proximal lesions in the period 1997-2001 and in the period 2002-2006.ResultsNeoplastic lesions were detected in 3087 people. Proximal CRC moved from 25.9% (1997-2001) to 30.0% (2002-2006). Adjusting for sex and age, the difference was not significant (OR 1.23; 95% CI: 0,95-1,58). The proximal ADP proportion increased from 19.2% (1997-2001) to 26.0% (2002-2006) (OR: 1.43; 95% CI: 1.17-1.89). The corresponding figures for advanced proximal ADP were 6.6% and 9.5% (OR: 1.48; 95% CI: 1.02-2.17). Adjusting for gender, age, diagnostic period, symptoms and number of polyps the prevalence of proximal advanced ADP was increased among people ≥ 70 years compared to those aged 55-69 years (OR 1.49; 95% CI: 1.032.16). The main predictor of proximal advanced neoplasia was the number of polyps detected per exam (> 1 polyp versus 1 polyp: considering all ADP: OR 2.16; 95% CI: 1.59-2.93; considering advanced ADP OR 1.63; 95% CI: 1.08-2.46). Adjusting for these factors, the difference between the two periods was no longer significant.ConclusionsCRC do not proximalize while a trend towards a proximal shift in adenomas was observed among people ≥ 70 years.

【 授权许可】

CC BY   
© Fenoglio et al; licensee BioMed Central Ltd. 2010