Detection Rate of Colorectal Adenoma or Cancer in Unselected Colonoscopy Patients: Indonesian Experience in a Private Hospital

Abstract

Background: Colorectal cancer is currently the third most common cancer in Indonesia, yet colonoscopy -the most accepted mode of screening to date -is not done routinely and national data are still lacking. Objective: To determine the detection rate of colorectal cancers and adenomas in unselected patients undergoing colonoscopy for various large bowel symptoms at the Digestive Disease and GI Oncology Centre, Medistra Hospital in Jakarta, Indonesia. Materials and Methods: Colonoscopy data from January 2009 to December 2012 were reviewed. New patients referred for colonoscopy were included. Data collected were patient demographic and significant colonoscopy findings such as the presence of hemorrhoids, colonic polyps, colonic diverticula, inflammation, and tumor mass. Histopathological data were obtained for specimens taken by biopsy. Associations between categorical variables were analyzed using chi-square test, while mean differences were tested using the t-test. Results: A total of, 1659 cases were included in this study, 889 (53.6%) of them being men. Polyps or masses were found in 495 (29.8%) patients while malignancy was confirmed in 74 (4.5%). Patients with a polyp or mass were significantly older (60.2 vs 50.8 years; p<0.001; t-test) and their presence was significantly associated with male gender (35.0% vs 23.9%; prevalent ratio [PR] 1.71; 95% confidence interval [CI] 1.38-2.12; p<0.001) and age >50 years (39.6% vs 16.6%; PR 3.29; 95% CI 2.59-4.12; p<0.001). Neoplastic lesions was found in 257 (16.1%), comprising 180 (11.3%) adenomas, 10 (0.6%) in situ carcinomas, and 67 (4.2%) carcinomas. Conclusions: Polyps or masses were found in 30% of colonoscopy patients and malignancies in 16.1%. These figures do not represent the nation-wide demographic status of colorectal cancer, but may reflect a potentially increasing major health problem with colorectal cancer in Indonesia.

The Clinical Significance of Colon Polyp Pathology in Nonalcoholic Fatty Liver Disease (NAFLD) and Its Impact on Screening Colonoscopy in Daily Practice

“…Obesity is also considered as an independent risk factor for CRC development [16]. Our large prospective study has shown the significant association between high BMI and presence of NAFLD [11].…”

“…Several risk factors were confirmed as independent risk factors for NAFLD, that is, obesity, male gender, age of more than 35 years, high triglyceride, low high-density lipoprotein (HDL) cholesterol, and high serum alanine aminotransferase levels [10]. Notwithstanding, retrospective data analysis study of a large sample size in the same private hospital for colon polyps or cancer detection rate found almost similar important risk factors, that is, older age (≥50 years old) and male gender [11].…”

Prevalensi Polip Kolorektal di RSUD Tarakan Tahun 2010-2016

“…Hal ini sesuai dengan penelitian yang dilakukan oleh Khan dkk pada tahun 1998. 9,10,11 Hasil penelitian juga sejalan dengan penelitian di Turki dengan 3514 sampel, 470 (13,3%) dimana sampel terbanyak dilakukan polipektomi didapatkan pada laki-laki (61,7%) dengan 66,4% sampel berusia diatas 50 tahun. 12 Pada kelompok polip adenoma, penderita polip diatas usia 50 tahun adalah 71,8% dan yang menderita polip adenoma sebanyak 63,9%.…”

Pencitraan dan Terapi Transcathether Arterial Chemoinfusion pada Unresectable Adenocarcinoma Colorectal

“…2 Angka mortalitas KKR di Indonesia 18.958 pasien pada tahun 2012, insiden dan mortalitas yang tinggi ini dikarenakan kurangnya deteksi dini dan kesadaran masyarakat terhadap KKR. 3 Dalam 10 tahun terakhir mortality rate KKR telah menurun lebih dari 20% karena meningkatnya perkembangan teknik diagnostik dan optimasi teknik bedah, terapi neoadjuvant dan paliatif. 4 Modalitas pencitraan yang digunakan dalam tatalaksana KKR saat ini sangat bervariasi dan heterogen di berbagai negara maupun institusi kesehatan.…”