title: Is proliferative colonic disease presentation changing?
abstract: OBJECTIVE
  To compare the site, age and gender of cases of colorectal cancer (CRC) and polyps in a single referral center in Rome, Italy, during two periods.
  
  
  METHODS
  CRC data were collected from surgery/pathology registers, and polyp data from colonoscopy reports. Patients who met the criteria for familial adenomatous polyposis, hereditary non-polyposis colorectal cancer syndrome or inflammatory bowel disease were excluded from the study. Overlap of patients between the two groups (cancers and polyps) was carefully avoided. The χ² statistical test and a regression analysis were performed.
  
  
  RESULTS
  Data from a total of 768 patients (352 and 416 patients, respectively, in periods A and B) who underwent surgery for cancer were collected. During the same time periods, a total of 1693 polyps were analyzed from 978 patients with complete colonoscopies (428 polyps from 273 patients during period A and 1265 polyps from 705 patients during period B). A proximal shift in cancer occurred during the latter years for both sexes, but particularly in males. Proximal cancer increased > 3-fold in period B compared to period A in males [odds ratio (OR) 3.31, 95%CI: 2.00-5.47; P < 0.0001). A similar proximal shift was observed for polyps, particularly in males (OR 1.87, 95%CI: 1.23-2.87; P < 0.0038), but also in females (OR 1.62, 95%CI: 0.96-2.73; P < 0.07).
  
  
  CONCLUSIONS
  The prevalence of proximal proliferative colonic lesions seems to have increased over the last decade, particularly in males.
authors.affiliation: Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, "Sapienza" University, 00189 Rome, Italy. vito.corleto@uniroma1.it
authors.forename: Vito D
authors.initials: VD
authors.lastname: Corleto
authors.forename: Cristiano
authors.initials: C
authors.lastname: Pagnini
authors.forename: Maria Sofia
authors.initials: MS
authors.lastname: Cattaruzza
authors.forename: Ermira
authors.initials: E
authors.lastname: Zykaj
authors.forename: Emilio
authors.initials: E
authors.lastname: Di Giulio
authors.forename: Giovanna
authors.initials: G
authors.lastname: Margagnoni
authors.forename: Emanuela
authors.initials: E
authors.lastname: Pilozzi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: D'Ambra
authors.forename: Antonietta
authors.initials: A
authors.lastname: Lamazza
authors.forename: Enrico
authors.initials: E
authors.lastname: Fiori
authors.forename: Mario
authors.initials: M
authors.lastname: Ferri
authors.forename: Luigi
authors.initials: L
authors.lastname: Masoni
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
authors.forename: Bruno
authors.initials: B
authors.lastname: Annibale
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Delle Fave
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D003111:Colonic Polyps / Q000175:diagnosis / Q000601:surgery; D003113:Colonoscopy; D005260:Female; D005762:Gastroenterology / Q000379:methods*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors