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Poster Session E - Tuesday Afternoon

Category: Colorectal Cancer Prevention

E0164 - Gender Differences and Disparities in Non-Malignant Colorectal Polyp Surgery in United States

Tuesday, October 25, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Deepa Wosti, MBBS

Chitwan Medical College
Kathmandu, Bagmati, Nepal

Deepa Wosti, MBBS¹, Pujan Kandel, MD², Dipesh Rohita, MBBS³, Bhaumik Brahmbhatt, MD², Massimo Raimondo, MD²
¹Chitwan Medical College, Kathmandu, Bagmati, Nepal; ²Mayo Clinic Jacksonville, Jacksonville, FL; ³B.P. Koirala Institute of Health Sciences, Jankpurdham, Janakpur, Nepal

Introduction: Cancer related death due to colorectal cancer is the third leading cause in both men and women. Annually, more than 1.1 million cases of colon cancer are diagnosed globally. The incidence rates of colorectal cancer are higher in men than in women. Most of the colon cancer are sporadic and arise from benign adenomas. Despite advancement in endoscopic management of large colorectal polyps, colectomies are still performed in United States. In addition, there is inadequate evidence of gender differences in surgery for nonmalignant colorectal polyps and prognosis. This study aims to examine the disparities/gender differences in surgery for non-malignant polyps from the National inpatient database.

Methods: This is a retrospective cohort study involving hospitalizations between January 1, 2012, and December 31, 2019, from the National Inpatient Sample (NIS). Our study sample included discharged adult patients (≥18 years old) hospitalized for non-malignant colonic or anorectal polyp as principal diagnosis and who underwent colectomy or proctectomy as a primary procedure. The principal or primary diagnosis is the unique diagnosis during the hospitalization for which the patient was primarily admitted or treated (NIS first diagnosis variable “I10_DX1”). The primary outcome of our study is to evaluate the disparities in surgical resection of nonmalignant colorectal polyp admissions over the above period. We used descriptive statistics to present patient demographics and hospital characteristics. Rates of in-hospital mortality is expressed as per 100,000 hospitalizations with surgery for principal nonmalignant colorectal polyp.

Results: There were 99330 primary admissions for surgical resection of non-malignant polyp resection in the United States from year 2012 to 2019. Fifty one percent were female (n=50191) and 66 % cases (n=59407) from academic hospitals. Majority were White Americans. Males had higher range of income threshold compared to females (p=0.001). However, females had significantly lesser in-hospital mortality, lower length of hospital stay, and less severe medical comorbidities (p=0.001) Tables 1 and 2.

Discussion: There was a significant decrease in-hospital mortality and lower length of hospital stay in females after surgery for non-malignant colorectal polyps over study periods. It is very important to understand the sociocultural differences and gender specific strategies for treatment.

Figure: Table 1. Baseline characteristics of the weighted sample from the NIS 2012–2019 for adults with non-malignant polyps who underwent surgery for a total weighted N=99,330.
Table 2. Unadjusted and adjusted in-hospital mortality among adult patients with surgery for non-malignant polyp (weighted n=82,995)

Table 1. Baseline characteristics of the weighted sample from the NIS 2012–2019 for adults

with non-malignant polyps who underwent surgery for a total weighted N=99,330.

Variables	Male n=49,139	Female n=50,191	P-value
Age (years), Standard deviation (SD)	65.5 SD=10.4	65.2 SD=10.7	< 0.064
Academic	66.12%	66.95%	0.236
Non-academic	33.88%	33.05%	0.236
Race: White Americans	79.28%	75.49%	< 0.001
Black Americans	10.78%	14.51%
Hispanic	5.69%	6.04%
Other Race	4.25%	3.96%
Charlson comorbidity index (CCI)-0	52.71%	57.66%	< 0.001
1	26.1%	26.34%
2	10.86%	9.19%
3 or higher	10.34%	6.81%
Annual Income: 1-45,999	178 (19.98)	186 (23.88)	0.024
46,000–58,999	226 (25.36)	223 (28.63)
59,000–78,999	262 (29.41)	210 (26.96)
79,000 or more	225 (25.25)	160 (20.54)
Length of stay (days) (95% CI)	5.3 (5.2–5.4)	4.8 (4.7–4.8)	< 0.001
In-hospital mortality (%)	0.65%	0.3%	< 0.001
AMI	5.79%	2.56%	< 0.001
CHF	4.93%	3.68%	< 0.001
PVD	4.21%	1.99%	< 0.001
CEVD	1.73%	1.53%	0.287
Dementia	0.37%	0.43%	0.501
COPD	14.96%	18.16%	< 0.001
Rheumatoid Disease	1.10%	2.33%	< 0.001
Hemiplegia	0.19%	0.07%	0.018
Kidney disease	8.07%	5.17%	< 0.001
Cancer	1.97%	1.32%	< 0.001
Peptic ulcer	0.54%	0.40%	0.176
Mild liver disease	1.47%	1.11%	0.027
Moderate/severe liver disease	0.52%	0.25%	0.003
Metastatic cancer	0.28%	0.24%	0.580
AIDS	0.04%	0.02%	0.448
Diabetes mellitus	21.97%	18.57%	< 0.001
Complication of DM	3.79%	2.34%	< 0.001
Unadjusted and adjusted in-hospital mortality among adult patients with surgery for non-malignant polyp (weighted n=82,995)

In-hospital mortality

Unadjusted Odds ratio

LL, UL 95% CI

P value

Adjusted Odds ratio

LL, UL 95% CI

P value

Academic (reference: Non-Academic

0.73

0.46, 1.15

0.174

0.80

0.50, 1.29

0.368

Sex (Reference: male) Female

0.46

0.30, 0.71

< 0.001

0.67

0.40, 1.08

0.101

Race (Reference:

White Americans)

Black Americans

Hispanic

0.96

0.93

0.50, 1.79

0.37, 2.30

0.863

0.872

0.96

0.99

0.47, 1.95

0.36, 2.73

0.914

0.984

Charlson Comorbidity Index (Reference: 0)

3 or higher

2.53

6.12

9.17

1.40, 4.60

3.33, 11.23

5.16, 16.31

0.002

< 0.001

1.99

5.56

6.12

0.97, 4.08

2.73, 11.35

3.0, 12.4

0.060

< 0.001

Disclosures:

Deepa Wosti indicated no relevant financial relationships.

Pujan Kandel indicated no relevant financial relationships.

Dipesh Rohita indicated no relevant financial relationships.

Bhaumik Brahmbhatt indicated no relevant financial relationships.

Massimo Raimondo indicated no relevant financial relationships.

Deepa Wosti, MBBS¹, Pujan Kandel, MD², Dipesh Rohita, MBBS³, Bhaumik Brahmbhatt, MD², Massimo Raimondo, MD². E0164 - Gender Differences and Disparities in Non-Malignant Colorectal Polyp Surgery in United States, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.