Mo1047 Evaluation of Computed Tomographic Colonography in Routine Practice in a Tertiary Referral Center

Abstract

histological diagnosis, location of the polyp, and preparation quality. Dysplasia was defined as the presence of any of the following: adenoma (of any kind), high grade dysplasia (HGD), or adenocarcinoma. In patients who had several polypectomies, the polyp with the highest degree of dysplasia and largest size was used for analysis. The primary outcome was the presence of dysplasia in colonic polyps. Covariates include age, gender, lesion size, use of aspirin, lesion site (right colon vs. Left colon, [right colon defined as starting at the splenic flexure]). Data was summarized as means (CI) or median (interquartile range) for skewed data. Multivariate logistic regression analysis was used to analyze the relationship between the primary outcome and the covariates. Results were reported at odds ratios (OR) with CI and p-values. Results: Our database includes 2400 patients who underwent a colonoscopy. Of those, 1237 were found to have polyps which were resected and analyzed. Those formed our study population. Indications for screening included screening, surveillance, or others (diarrhea, bleeding, etc). Baseline characteristics are reported in table 1. Multivariate logistic regression analysis showed that the right colon did have a significant association with dysplasia when controlling for age, gender, polyp size, use of aspirin and withdrawal time, (OR = 3.1 [2.3 4, p=<0.0001). Polyp size was associated with increased risk of dysplasia (OR= 1.04 [1.01 1.07], p=0.0089). Age was also found to be associated with increased odds of dysplasia (OR =1.03 [1.02 1.04], p=<0.0001). Female gender was associated with decreased odds of finding dysplasia (OR=0.6 [0.46 0.78], p=0.03). Use of aspirin was not associated with decrease odds of finding dysplasia (OR=0.8 [0.6 1.076], p=0.14). Conclusion: Patient characteristics (male and gender) as well procedure findings (increase polyp size and right sided lesions) are associated with increased odds of dysplasia. In older males, extra time/attention should be devoted to detection and removal of right sided lesions which are more likely to have dysplasia. Table 1: patient characteristics