Gender differences in colorectal polyps and tumors.
OBJECTIVE
To use a national endoscopy database (CORI) to determine 1) whether gender differences are noted in the prevalence and location of polyps and tumors; 2) whether women have a higher rate of right-sided polyps or tumors; and 3) whether age influences these results.


METHODS
CORI database from April 1, 1997 to February 19, 1999, captured in a computer-generated report, was analyzed. Polyps for this study were defined as sessile or pedunculated and as >9 mm. Tumors were defined as lesions characteristic of adenocarcinoma (mass, apple-core). Pure right-sided colon (PRS) was defined as cecum, ascending, hepatic flexure; right-sided as PRS plus the transverse colon; and left-sided as the splenic flexure, descending, sigmoid and rectum.


RESULTS
Men have a greater risk of polyps [odds ratio (OR), 1.5] and tumors (OR, 1.4) than women. The risk of finding polyps and tumors at colonoscopy increases with age, with the highest risk noted in those >69 yr of age relative to patients <50 yr of age (polyps, OR = 2.7; tumors, OR = 4.0). Right-side polyps and pure right-sided polyps as defined by the study design were noted to be more frequent than left-sided polyps in patients >60 yr of age. Women have a greater risk of developing pure right-sided polyps (OR, 1.2), tumors (OR, 1.6) and right-sided tumors (OR, 1.5) than men.


CONCLUSIONS
Men have a higher prevalence of colon polyps and tumors than women. A progressive risk of polyp or tumor formation is noted with aging. Women had a greater number of pure right-sided polyps and tumor development. Colonoscopy is needed to correctly diagnose an increasing prevalence of right-sided pathology in the elderly.
Department of Medicine, University of Nebraska Medical Center, Omaha 68198-3285, USA.
T M
TM
McCashland
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R
Brand
E
E
Lyden
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P
de Garmo
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000473:pathology; D017677:Age Distribution; D000368:Aged; D003111:Colonic Polyps / Q000453:epidemiology* / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012002:Rectal Diseases / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States