Prevalence of nonpolypoid colorectal neoplasia: an Italian multi center observational study

Background and study aim: The aim of this study was to assess the prevalence of nonpolypoid lesions (NPLs) in Italy and their risk of containing neoplasia or advanced histology. Patients and methods: This was a multicenter cross-sectional observational study on consecutive patients undergoing total colonoscopy over a 3-month period in 80 Italian centers. Results: In all, 27400 total colonoscopies were analyzed. Cancer was diagnosed in 801 patients (2.9%). A total of 6553 precancerous lesions were detected in 5609 patients. Of these, 4154 patients (74.1%) had polypoid lesions and 1455 patients (25.9%) had NPLs. Therefore, the prevalence of NPLs was 5.3% (95%CI 5.05.6). NPLs larger than 10mm were detected in 254 patients (17.5%). NPLs were more predominant in the proximal colon (OR 2.92, 95%CI 2.563.43; P<0.0001 vs. polypoid lesions). Neoplastic tissue was diagnosed in 79.0% and advanced histology (high-grade intraepithelial neoplasia or more) in 20.9% of resected lesions. The risk of advanced histology was similar for polypoid and nonpolypoid lesions when adjusted for size. Depressed lesions had the highest risk of advanced histology (OR 10.56, 95%CI 6.0218.55; P<0.0000 vs. flat-elevated). Age was an independent predictor of both neoplasia and advanced histology (P=0.0001). Conclusions: NPLs are relatively common in the Italian population, with a prevalence similar to that in other Western series. NPLs are not more aggressive than polypoid lesions, except for those with depressed morphology. © Georg Thieme Verlag KG Stuttgart · New York.