There are lesions that are still being missed in colonoscopy. Many of those could be superficially elevated serrated lesions or depressed ones.
The aim of this study was to compare the histopathological characteristics of these lesions and their risks for submucosal carcinoma.
This is a retrospective, cross-sectional, and observational study comparing 217 superficially elevated serrated lesions larger than 5 mm resected by colonoscopies (G1) with 558 depressed lesions (G2).
In G1, 217 lesions were found in 12,653 (1.7%) colonoscopies; in G2, 558 lesions were found in 36,174 (1.5%) colonoscopies. In G1, 63.4% were women and in G2, there was no gender predominance. The average size of G1 was 16.2 mm and G2 was 9.2 mm (p<0.001). G1 predominated on the proximal colon and G2 on the distal and rectum (p<0.001). In G1, there were 214 (98.6%) low-grade intramucosal neoplasia and 3 (1.4%) high-grade intramucosal neoplasia. Excluding 126 hyperplastic polyps and considering 91 sessile serrated adenomas in G1, we observed 88 (96.7%) low-grade intramucosal neoplasia and 3 (3.3%) high-grade intramucosal neoplasia; in G2, we observed 417 (74.7%) low-grade intramucosal neoplasia, 113 (20.3%) high-grade intramucosal neoplasia, and 28 (5.0%) submucosal adenocarcinomas (p<0.001).
Depressed lesions significantly had more high-grade intramucosal neoplasia and more invasive carcinomas in the submucosal layer than superficially elevated serrated lesions and more than superficially elevated sessile serrated adenomas.
Colorectal cancer (CRC) is a worldwide health problem whose control depends on public policy establishment and effective prevention and screening programs. In Brazil, there are few studies related to adherence to screening methods.
The aim of this study was to evaluate the association between demographic and socioeconomic to adherence to CRC screening with fecal immunochemical test (FIT) among average-risk individuals for CRC.
In this prospective cross-sectional study, conducted between March 2015 and April 2016, 1,254 asymptomatic individuals aged 50–75 years, participating in a hospital screening campaign in Brazil, were invited to participate in the study.
The adherence rate to FIT was 55.6% (697/1,254). In the multivariable logistic regression analysis, patients aged 60–75 years (odds ratio (OR)=1.30; 95% confidence interval (CI): 1.02–1.66; p=0.03), religious belief (OR=2.04; 95% CI: 1.34–3.11; p<0.01), previous fecal occult blood test (OR=2.07; 95% CI: 1.55–2.76; p<0.01), and full/part-time working status (OR=0.66; 95% CI: 0.49–0.89; p<0.01) were independently associated with adherence to CRC screening.
The results of the present study highlight the importance of considering the labor aspects when implementing screening programs, suggesting that campaigns conducted in the workplace and repeated over the years may be more effective.
Desenvolvido por Surya MKT