Abstract
Background: Screening colonoscopy has historically been recommended starting at the age of 50. However, the recommended age for beginning screening has recently been reduced to 45 independent of sex. However, studies on screening colonoscopies of average-risk individuals in China are sparse. This study aimed to determine and compare the prevalence of adenomas, advanced adenomas (AAs), and colorectal cancers (CRCs) and the number of individuals needing screening in an average-risk Chinese population of different ages and sexes.Methods: A total of 53,152 individuals undergoing colonoscopy were included from January 2013 to December 2019. We analysed and compared the prevalence of adenomas, AAs, and CRCs and the number of individuals needing screening in different age groups of men and women.Results: The average age of males was 48.80 years (SD, 8.47 years), that of females was 50.00 years (SD, 9.00 years), and the sex ratio was 66.28% (n=35,226) vs. 33.72% (n=17,926). The prevalence of adenomas, AAs, serrated adenomas and CRCs was 14.51% ([95% CI 14.21–14.81], n=7713), 3.04% ([95% CI 2.90–3.19], n=1617), 1.23% ([95% CI 1.01–1.32], n=653) and 0.59% ([95% CI 0.52–0.65], n=313), respectively. Male sex was significantly associated with a high prevalence of adenomas (17.14% [95% CI 16.74–17.53] vs 9.36% [95% CI 8.94–9.79], P<0.001), AAs (3.67% [95% CI 3.47–3.87] vs 1.81% [95% CI 1.61–2.00], P<0.001) and serrated adenomas (1.56% [95% CI 1.43–1.69] vs. 0.59% [95% CI 0.47–0.70], P<0.001). The prevalence of AAs in 45- to 49-year-old individuals was 3.17% (95% CI 2.80–3.55) in men and 1.49% (95% CI 1.12–1.86) in women. The number of men needing screening(NNS) was 31.55 (95% CI 28.17–35.71), while the number of women was 67.11 (95% CI 53.76–89.29). The prevalence and number of patients needing screening for AAs in men aged 45–49 years were close to those in women aged 65–69 years (31.55 [95% CI, 28.17–35.71] vs. 29.07 [95% CI, 21.05–46.73]).Conclusions: The prevalence of adenomas, AAs, and serrated adenomas increased with age. Males had a higher prevalence rate than females. The prevalence and NNS of AAs in 45- to 49-year-old men were close to those in 65- to 69-year-old women.
Characteristics of Serrated Adenomas in Non-Hispanic Whites and African Americans Undergoing Screening Colonoscopy