Ethnic Variation of Colonic Polyps
Techapaitoon S, MD¹, Permpoon VS, MD¹, Pongpirul K, MD, MPH, PhD² , ³ , ⁴, Anuras S, MD¹
Affiliation : ¹ Digestive Disease Center, Bumrungrad International Hospital, Bangkok, Thailand ² Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ³ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA ⁴ Bumrungrad Research Center, Bumrungrad International Hospital, Bangkok, Thailand
Background: With more than 5,000 colonoscopies provided to patients from almost 200 countries annually, the data in
Bumrungrad Colonoscopy Registry (BCR) is beneficial for comparative analysis across ethnic groups.
Objective: To describe the results of colonoscopy findings of colonic symptom-free patients from various ethnic groups.
Materials and Methods: Using the BCR dataset, a random sample of subjects underwent colonoscopy between 2007 and 2011 were reviewed. Patients aged at least 50 years without colonic symptoms or history of colonic diseases were included.
Results: Of the 26,508 subjects, 2,651 were randomly selected and 1,300 subjects met the inclusion criteria. Abnormal findings were identified in 878 cases (67.54%), of which 452 cases were found to have 940 polyps. Seven cancer lesions were found in six cases. Of the 452 patients, half had only one polyp (53.76%) and were Asian (54.65%), followed by Caucasian (26.99%), and Middle Eastern (15.71%). Ethnicity-specific polyp incidences were 36.26%, 38.05%, and 27.24%, respectively. Polyps of Caucasian subjects tended to be smaller (4.52 mm) and locate on the left side of colon (65.63%) more than that of the other ethnicities (44.44% to 60.53%). Most of the polyps (84.04%) were small (≤5 mm). Hyperplastic polyp, tubular adenoma (TA), and tubulovillous adenoma (TVA) were identified in 43.19%, 53.83%, and 2.34%, respectively. Pre-malignant (TA+TVA) polyps were found in 56.08%, 50.19%, and 64.23% of the polyps of Asian, Caucasian, and Middle Eastern patients, respectively. Interestingly, pre-malignant lesions were found in 52.91% of the small polyps.
Conclusion: Number, size, distribution, and pathological type of colonic polyps vary across ethnic groups. As more than half of small polyps were TA, polyps of all sizes should be removed when feasible.
Keywords : Colonoscopy, Polyps, Colon cancer, Epidemiology, Ethnicity
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