Colorectal adenomatous and serrated polyps in rural South Australia: who, why, what and where?

• Published in: ANZ journal of surgery Vol. 93; no. 12; pp. 2939 - 2945
• Main Authors: Watson, Matthew M., Besley, Matthew, Beukes, Eben, Bhattacharjya, Shantanu, Bierton, Christopher, Bruening, Martin, Chaloob, Salim, Dobbins, Christopher, Estakhri, Aliakhbar, Finlay, Ben, Gan, Siang, Gunning, Thomas, Green, Luke, Harris, Mark, Hassen, Tiffany, Heitmann, Paul, Humeniuk, Vladimir, Hussain, Rafat, Kanhere, Harsh, Kiroff, George, Khoo, Teng‐Wei, Kuan, Li Lian, Lauder, Christopher, Lim, Alicia, Lu, Victoria, Maddern, Guy, McCullough, Timothy, Olakkengil, Santosh, Pradhan, Chetan, Prasad, Shalvin, Ralph, Quentin, Shepherdson, Mia, Smith, Richard, Thakore, Nainoor, Ting, Ying Yang, Traeger, Luke, Trochsler, Markus, Watson, Matthew, Wichmann, Matthias, Watson, Dianne C., Maddern, Guy J., Wichmann, Matthias W.
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.12.2023; Blackwell Publishing Ltd
• Subjects: Adenoma; Adenoma - diagnosis; Adenomatous Polyps - epidemiology; Adult; Age; Aged; Aged, 80 and over; Australia - epidemiology; Blood; Cancer; Colonic Polyps - pathology; Colonoscopy; Colonoscopy - methods; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - pathology; Gender; Histopathology; Humans; Indication; Male; Middle Aged; Polyps; rural surgery; serrated polyp; South Australia - epidemiology; Tumors; Variation; Australia; South Australia; adenoma; serrated polyp; rural surgery; colonoscopy
• ISSN: 1445-1433; 1445-2197; 1445-2197
• DOI: 10.1111/ans.18662

Backgrounds The adenoma‐carcinoma and serrated pathways offer a window of opportunity for the removal of pre‐malignant polyps and prevention of colorectal cancer (CRC) through the use of colonoscopy. The aim of this study was to investigate variation in polyp incidence in different age groups, gender and indications for undertaking colonoscopy. We also address histological types of polyps found and where in the bowel they are located. Methods This study is based on the colonoscopy data collected prospectively over a one‐year period in multiple South Australian rural centres, 24 general surgeons contributed to this study. All histopathology results were subsequently entered into the dataset. Results A total of 3497 colonoscopies were performed, with a total of 2221 adenomatous and serrated polyps removed. Both serrated and adenomatous polyps were more common in the distal colon. Patients of male gender, aged 70 years and over and with an indication of polyp surveillance had higher adenoma and serrated polyp detection rates (ADR and SPDR). Patients aged 40–49 years old who underwent colonoscopy for positive faecal occult blood had an ADR and SPDR of 25.0% and 6.3%, respectively. Conclusions This study has shown variation in ADR and SPDR depending on age, gender and indication for colonoscopy. This variation will help further develop key performance indicators in colonoscopy. The high ADR and SPDR in patients aged 40–49 years old whom underwent colonoscopy for positive faecal occult blood may support lowering the age of commencement of CRC screening in Australia. This study is based on the data collected prospectively over a one‐year period in seven South Australian rural centres. We investigate variation in polyp incidence in different age groups, gender and indications for undertaking colonoscopy. We also address histological types of polyps found and where in the bowel they are located. Variation may impact colorectal cancer screening practices and assist in developing appropriate key performance indicators in colonoscopy for adenoma and serrated polyp detection rate.