P1295 - Outcomes of Large Polyp Removal in the Elderly at a Tertiary Health Care Network: Does Polyp Location Matter?

Hammad Liaquat, MD¹, Janak Bahirwani, MD¹, Hussam Tayel, MD¹, Brittney Shupp, DO², Nishit Patel, MD³, Blessing Jerome, DO¹, Pooja Saraiya, DO¹, Yecheskel Schneider, MD¹, Kimberly Chaput, DO^4
1St. Luke's University Health Network, Bethlehem, PA; ²St. Luke's University Hospital, Bethlehem, PA; ³St. Luke's University Hospital, Easton, PA; ⁴St. Luke's University Health Network, Fountain Hill, PA

Introduction: The risk for colorectal cancer (CRC) increases in patients with large colonic polyps or advanced adenomas. Our aim was to determine the risk factors associated with location of such polyps in the elderly aged 75 years and above.

Methods: We conducted a retrospective chart review to identify patients who underwent a colonoscopy between the years of 2012 to 2020 and were over age of 75 years. We collected data on patient characteristics, colonoscopy findings and histology of polyps. Exclusion criteria were patients with a history of CRC, polyposis syndromes, or Inflammatory Bowel Disease or when large polyps were removed in proximal and distal colon during the same colonoscopy. Inclusion criteria was all colonoscopies being performed where large polyps were removed in either proximal or distal colon. Statistical analyses were conducted in SPSS version 26.

Results: A total of 1749 colonoscopies were analyzed and 123 met the inclusion criteria. Median age was 79. Most of the patients were Caucasian (85.3%) and female (56.1%), with history of hypertension (90.2%) and ASA level 3 or more (56.1%). Good bowel preparation and high cecal intubation rates were seen. A significant proportion of patients took aspirin (47.2%), diabetics (39.1%) had metabolic syndrome (34.1%) or were ex-smokers (33.3%). Higher proportion of large polyps (65.9%) and colon cancer (62.5%) were found in proximal colon. Higher proportion of patients with proximal large polyps had a history of CAD, aortic stenosis, COPD, obesity, diabetes, low HDL than those with large polyps in distal colon (Table 1). High triglyceride levels and CHF was seen in larger proportion of patients with distal colon large polyps. Iron deficiency anemia (IDA) was found in minority of patients regardless of polyp location (29.3% vs 31.7%), while it was found in 50% patients with colon cancer out of which most had proximally located cancer (66.6% vs 33.3%).

Discussion: Our limited study shows significant proportion of large polyps in the proximal colon in the elderly which is higher than reported in past literature while higher prevalence of such lesions in women was in contrast to results in past studies. Higher comorbidity was observed in patients with proximally located large polyps which needs further analysis. Our findings help to justify long term teaching that IDA in the elderly need to be investigated as advanced adenomas and proximal CRC can be potential etiologies according to our results. Larger studies are needed to validate our results.



Disclosures:


Hammad Liaquat, MD¹, Janak Bahirwani, MD¹, Hussam Tayel, MD¹, Brittney Shupp, DO², Nishit Patel, MD³, Blessing Jerome, DO¹, Pooja Saraiya, DO¹, Yecheskel Schneider, MD¹, Kimberly Chaput, DO⁴. P1295 - Outcomes of Large Polyp Removal in the Elderly at a Tertiary Health Care Network: Does Polyp Location Matter?, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.