Long-term follow up after colonoscopy screening and polypectomy of male health care population with age ≥ 50 years

Abstract

To analyze the trends of colorectal polyps for age ≥ 50 years male healthcare patients during a long-term colonoscopic follow-up. Endoscopic and pathological reports of age ≥ 50 years male healthcare patients undergoing colonoscopy from April 1983 to April 2013 were retrospectively reviewed and their general data collected. The proportion of different histological types, the distribution at different anatomic sites and the trends of size and number of colorectal polyps during different follow-up years were analyzed. A total of 3 746 colonoscopy reports of 501 age ≥ 50 years healthcare cases were collected. After initial colonoscopic screening and polypectomy, 501, 371, 251 and 106 cases were followed up to the 5(th), 10(th), 15(th) and 20(th) years. Their mean age was (74 ± 9) years. And their mean age of initial colonoscopic screening and polypectomy was (66 ± 8) years. During a follow-up period of 54-348 months, each of them underwent (7 ± 5) colonoscopies. A total of 9 006 polyps were detected and 3 986 polyps confirmed pathologically. And 2 608 polyps(65.43%) belonged to adenomas. Among them, 4 638 (51.50%) polyps were located in descending colon and rectum while 1 314 (14.59%) in ascending colon and cecum.In a descending trend, the sizes of initial colonoscopy, 5(th), 10(th), 15(th) and 20(th) year were 0.44 ± 0.03, 0.07 ± 0.01, 0.07 ± 0.01, 0.12 ± 0.03 and 0.07 ± 0.01 respectively during the follow-up period (all P < 0.05). Also the numbers were in a descending trend, initial colonoscopy, 5(th), 10(th) and 20(th) year were 3.08 ± 0.19, 0.77 ± 0.09, 0.83 ± 0.10 and 1.03 ± 0.20 respectively during the follow-up period (all P < 0.05). The numbers of four different pathological types of polyps were all in a descending trend compared with initial colonoscopy. And the numbers peaked around 2(nd), 5(th), 7(th), 10(th), 11(th), 15(th), 18(th) and 19(th) year of follow-up. Statistical differences existed between tubular adenoma and tubule-villous adenoma, inflammatory polyps and hyperplastic polyps in mean number in the same follow-up year (all P < 0.05). The number of colorectal polyps in different anatomic sites was different in the same follow-up year (all P < 0.05). The mean age of initial colonoscopic screening and polypectomy is 66 years. And the main histological type of colorectal polyps is adenoma.Rectum, sigmoid and descending colon are the major sites of colorectal polyps. During the follow-up, the size and number of colorectal polyps are both in a descending trend and the number changes with years. The recurrence of colorectal polyps has pathological and anatomical disparities during follow-up years.