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Subject Area

Orthopedic Surgery

Article Type

Original Study

Abstract

Background Advanced age is a risk factor for the development of colorectal polyps and advanced adenomas (AA). However, few studies have investigated the features of colorectal polyps in the elderly. Objective To study different characteristics of colorectal polyps in Egyptian elderly patients in the Gastroenterology Endoscopy Center of Alexandria University Main Hospital. Patients and methods Between February 2018 and February 2020, 1852 patients underwent colonoscopy. Inclusion criteria were patients aged more than or equal to 65 years, a positive family history of colorectal polyps/cancer, chronic diarrhea, constipation, or chronic abdominal pain, unexplained weight loss, unexplained anemia, and rectal bleeding/hematochezia. Patients with no polyps or unresectable polyps on colonoscopy, and patients with a history of colectomy or proctectomy were excluded from the study. Results Patients were divided into three groups regarding age: 65–69 years (34%), 70–79 years (55.5%), and more than or equal to 80 years (10.5%). The mean age was 75.4 ± 4.2 years. A total of 253 (50.3%) of the patients were male and 250 (49.7%) were female. Patients from urban areas represented 62.8%, whereas 37.2% were from rural areas. Patients with positive family history represented 29.8%. Clinical presentations were constipation (21.2%), diarrhea (18.7%), abdominal pain/distension (15.7%), rectal bleeding or hematochezia (10.7%), loss of weight (9.3%), anemia (7.2%), positive fecal occult blood (6%), and regular health examination (11.3%). Histologically, 61.8% were nonadenomatous polyps, and 38.2% were adenomatous polyps, and of them, 47.9% were Non-advanced adenomatous polyps (NAAPs) and 52.1% were AAs. Concerning adverse affected, 39.1% were on right-sided colon and 60.8% on the left side. Regarding the size, 303 (60.2%) were minute less than or equal to 5 mm in their greatest dimension, 138 (27.4%) were 6–9 mm, 45 (8.9%) were 10–20 mm, and 17 (3.4%) were more than 20 mm. Larger polyps were more likely to be adenomatous, and advanced, even when the cutoff size was set at 5 mm. Conclusion The incidence of colorectal polyps increases with age. AAs were noticed more commonly in elderly females. Although AAs were commonly noticed in polyps with 0–III morphology and size more than or equal to 10 mm, a respectable percentage of AAs was noticed in minute and small polyps; therefore, these polyps should not be ignored and should be followed up.

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