Histopathological and epidemiological findings of colonoscopy screening in a population with an average risk of colorectal cancer in Kuwait
Hassan B Abdelnaby1, Ali A Abuhussein2, Ahmed M Fouad3, Wafaa A Alhashash2, Abdulrahman S Aldousari2, Ahmed M Abdelaleem4, Marcus Edelhamre5, Maha H Shahin2, Mohammed Faisal6
1 Department of Endemic and Infectious Diseases, Faculty of medicine, Suez Canal University, Ismailia, Egypt; Department of Internal Medicine, Division of gastroenterology, Al Sabah Hospital, Ministry of Health, Kuwait
2 Department of Internal Medicine, Division of gastroenterology, Al Sabah Hospital, Ministry of Health, Kuwait
3 Department of Public Health, Occupational and Enivronmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
4 Department of Internal Medicine, Division of gastroenterology, Al Sabah Hospital, Ministry of Health, Kuwait; Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
5 Department of Surgery, Helsingborg Hospital, Helsingborg, Sweden
6 Department of Surgery, Helsingborg Hospital, Helsingborg, Sweden; Department of Surgery, Surgical Oncology Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Dr. Hassan B Abdelnaby
Department of Internal Medicine, Division of Gastroenterology, Al Sabah Hospital, Ministry of Health, P. O. Box (5) – 13001, Safat
Source of Support: None, Conflict of Interest: None
Background: Colorectal cancer (CRC) is the second most common cancer in women and the third most common in men worldwide, with a significantly rising incidence in the Middle East region over the last few decades. This study investigates the histopathological and epidemiological characteristics of colonoscopic findings in a population with an average risk of CRC in Kuwait.
Methods: In this study, 1,005 asymptomatic average-risk Kuwaiti adults aged over 40 years had their first colonoscopy screening during the 2015–2018 period. Data on lifestyle behaviors (cigarette smoking, alcohol consumption, and physical activity), body mass index (BMI), and comorbidities were routinely collected from these individuals. All colorectal polyps or masses were assessed for their site, size, and number and then resected and sent for histopathological examination.
Results: The mean age of the participants was 54 years, and 52.2% were women. In screened individuals, the polyp detection rate, adenoma detection rate, and carcinoma detection rate were 43.8%, 27.7%, and 1.2%, respectively. Tubular, tubulovillous, and villous types of adenoma constituted 17.3%, 2.8%, and 1.3% of all screened participants. Neoplastic lesions, particularly in the proximal colon, were more common among men aged 40–49 years. Age of 70 years and older (OR: 9.6; 95% CI: 4.7–19.9; P < 0.001), male gender (OR: 1.6; 95% CI: 1.1–2.3; P = 0.011), increased BMI (OR: 1.05; 95% CI: 1.02–1.08; P = 0.001), and smoking (OR: 3.5; 95% CI: 2.3–5.4; P < 0.001) were the most significant independent risk factors for colorectal neoplasia.
Conclusions: The high adenoma detection rate (ADR) in Kuwaiti population calls for the establishment of a national programe for CRC screening. The higher ADR in those younger than 50 years calls for assessment of the threshold age at which to start screening.