[An analysis of results of the elderly colorectal cancer screening study]

To evaluate the detection rates of colorectal polyps and cancer in the elderly and characterize the pathological features of the colorectal neoplasm in DongLi District in Tianjin.

Totally, 46 743 subjects aged 60-74 were recruited from the national colorectal cancer screening program, including subjects registered from November 2012 to April 2013 in DongLi District in Tianjin. Each subject completed a questionnaire and a fecal occult blood test. Colonoscopies were conducted in 434 subjects with high risk for colorectal cancer.

Among all the subjects, 2 880 were at high risk for colorectal cancer which accounts for 6.16% (2 880/46 743) of the total subjects. Among the subjects who underwent the colonoscopy, 165 (men: 105, women: 60) were colorectal polyps accounting for 5.73% (165/2 880) in the total risk, with 51 subjects (1.77%) advanced neoplasms and 4 subjects (0.14%) cancer. The detection rates of colorectal polyps is 0.35% (165/46 743), and colorectal cancer is 8.6/10(5) (4/46 743). More polyps were found on the left colon compared with the right. More tubular adenoma was found compared with the other pathological types. Most of the polyps were smaller than 0.5 cm. Colorectal polyps and advanced neoplasms were more frequent in men than women [45.45% (105/231) vs 29.56% (60/203), 16.02% (37/231) vs 6.90% (14/203), all P < 0.01]. Multiple polyps (P < 0.05) and polyps with diameter larger than 1.0 cm (P < 0.01) were more often in men than in women. Men tended to have more colorectal polyps in right colon and higher detection rate for moderate or sever atypical hyperplasia than women (all P < 0.05).

There is a higher incidence of colorectal polyps in the elderly. It is important to establish the national sequential colorectal cancer screening program for the early diagnoses of colorectal polyps and cancer in the elderly.