Spectrum of Colorectal Polyps in Southern India: A Twin Centre Ambispective Study

Abstract

Introduction: Intestinal polyps are grossly visible tumours which protrude (into lumen of gastrointestinal tract). Majority of the polyps are benign in the paediatric age group. However in adults, they may be harbingers of more serious genetic, familial or developmental disorders and some of them may be premalignant. Aim: Our aim was to study the distribution, histological varieties of colorectal polyps and to examine dysplasia in adenomatous polyps and its determinants. Materials and Methods: This is a four years retrospective and one year prospective study from June 2017 to May 2022 conducted at Upgraded Department of pathology, Osmania General Hospital and a tertiary care centre, Shadan institute of medical sciences, Hyderabad. A total of 110 cases of polyps were studied which included 62 cases in adults and 48 cases in children (0-12 years). Predictors of dysplasia in adenomatous polyps were studied. Results were analysed using PSPP software. Results: There were 62.73% (69) males and 37.27% (41) females. The commonest clinical presentation was bleeding from rectum 64.54% (71) cases. Rectosigmoid was the commonest site in 83.64% (92) cases. Juvenile polyps were the commonest in children and constituted 89.58% (43 cases). In adults, there were 63.07% (41) adenomatous polyps. A statistically significant association has been observed between high grade dysplasia and size (p-value 0.015) and villous architecture (p-value 0.02). There was no statistically significant association with site (p-value 0.2). Conclusion: A rising incidence of Colorectal Cancer (CRC) has necessitated identification of preneoplastic Adenomatous polyps which may progress to carcinoma via the Adenomacarcinoma sequence. Polyps occurring as part of polyposis syndromes have increased neoplastic potential. Their detection and treatment carries significant implications both for the patients and their families. In India, there is a need for screening colonoscopy in asymptomatic individuals which can be a potential cancer prevention tool.