GENDER-SPECIFIC DIFFERENCE IN HISTOLOGY OUTCOMES ACCORDING TO POLYP SHAPE IN SCREENING COLONOSCOPIES

Aims:

Predictions about histology can be made due to polyp's size, localization and shape. As influence of size and localization have been already shown in many studies (Lieberman D et al, Gastroenterology 2008), our aim of the study was to evaluate probabilities for type of histology according to different polyp shapes and whether it shows distinction between men and women.

Methods:

Screening colonoscopies between 2007 – 2018 were analyzed within Austrian Certificate in Quality for Screening Colonoscopy. Polyp shape was recorded on basis of Paris classification (sessile, flat, pedunculated). Histology was described for polyps: hyperplastic, other benign and for adenomas: tubular, villous, tubulovillous, sessile serrated (SSA), traditional serrated (TSA). Advanced adenomas (AA) were analyzed between 2013 – 2018.

Results:

27 666 (46,88%) screening colonoscopies were from female patients, mean age = 61,76 (SD = 8,96),53,12% were from male patients, mean age = 61,41 (SD = 8,92).

7766 (49,28%) flat polyps were found in women, 7992 (50,72%) in men. Regarding histology, 51,96% were hyperplastic in women vs.44,73% in men, other benigne 4,96% vs.4,7%, SSA 3,84% vs.2,34%, TSA 0,66% vs.0,34%, tubular 33,29% vs.41,37%, tubulovillous 5,07% vs.6,19% and villous 0,23% vs.0,33%.

From 2537 (42,78%) pedunculated lesions in women and 3394 (57,22%) in men, 16,71% were hyperplastic in women vs.14,11% in men, other benigne 6,39% vs.5,48%, SSA 0,63% vs.0,68%, TSA 0,43% vs.0,47%, tubular 47,46% vs.50,88%, tubulovillous 27,24% vs.27,37% and villous 1,14% vs.1,0%.

According to sessile polyps,17 363 (46,52%) were found in women and 19958 (53,48%) in men. From that,47,49% were hyperplastic in women vs.42,31% in men, other benigne 4,56% vs.4,2%, SSA 3,04% vs.2,11%, TSA 0,52% vs.0,47%, tubular 37,85% vs.43,65%, tubulovillous 6,16% vs.6,89% and villous 0,38% vs.0,42%.

From 39 886 screening colonoscopies since 2013, 4,53% AA were found in women and 6,06% in men. Regarding to polyp's shape, 6,26% of flat polyps (5 430) in women were AA vs.7,8% in men (5 432),41,01% of pedunculated polyps (1 517) vs. 41,05%(from 2073) and 7,13% of sessile polyps (11 848) vs. 8,43% (from 13 586).

Conclusions:

Patients with pedunculated polyps had higher risk for advanced histology compared to sessile or flat polyps. More men had pedunculated and sessile lesions.

More sessile and flat polyps turned out to be histologically hyperplastic and SSA among women whereas men had more tubular adenomas with these polyp shapes.