Detection Rate of Colorectal Adenoma or Cancer in Unselected Colonoscopy Patients: Indonesian Experience in a Private Hospital

Background: Colorectal cancer is currently the third most common cancer in Indonesia, yet colonoscopy - themost accepted mode of screening to date - is not done routinely and national data are still lacking.
Objective: Todetermine the detection rate of colorectal cancers and adenomas in unselected patients undergoing colonoscopyfor various large bowel symptoms at the Digestive Disease and GI Oncology Centre, Medistra Hospital in Jakarta,Indonesia. Materials and
Methods: Colonoscopy data from January 2009 to December 2012 were reviewed.New patients referred for colonoscopy were included. Data collected were patient demographic and significantcolonoscopy findings such as the presence of hemorrhoids, colonic polyps, colonic diverticula, inflammation,and tumor mass. Histopathological data were obtained for specimens taken by biopsy. Associations betweencategorical variables were analyzed using chi-square test, while mean differences were tested using the t-test.
Results: A total of, 1659 cases were included in this study, 889 (53.6%) of them being men. Polyps or masses werefound in 495 (29.8%) patients while malignancy was confirmed in 74 (4.5%). Patients with a polyp or mass weresignificantly older (60.2 vs 50.8 years; p<0.001; t-test) and their presence was significantly associated with malegender (35.0% vs 23.9%; prevalent ratio [PR] 1.71; 95% confidence interval [CI] 1.38-2.12; p<0.001) and age>50 years (39.6% vs 16.6%; PR 3.29; 95% CI 2.59-4.12; p<0.001). Neoplastic lesions was found in 257 (16.1%),comprising 180 (11.3%) adenomas, 10 (0.6%) in situ carcinomas, and 67 (4.2%) carcinomas.
Conclusions: Polypsor masses were found in 30% of colonoscopy patients and malignancies in 16.1%. These figures do not representthe nation-wide demographic status of colorectal cancer, but may reflect a potentially increasing major healthproblem with colorectal cancer in Indonesia.