The predictive factors of precancerous lesions and colorectal cancer in Wiengsa Crown Prince Hospital, Surat Thani
Keywords:
Colorectal Cancer Screening, Polyps, Precancerous lesionAbstract
Background Colorectal cancer (CRC) is one of the leading causes of global cancer-related mortality. Most CRC cases arise from precancerous lesions, such as adenomatous and sessile serrated polyps, which can be detected and removed through colonoscopy. However, the epidemiological profile and risk factors for CRC and precancerous lesions in Thailand, especially in secondary care settings, remain underexplored.
Objective This study identified the demographic and clinical predictors of colorectal neoplasia, including precancerous lesions and CRC, among patients undergoing colonoscopy at Wiengsa Crown Prince Hospital in Surat Thani, Thailand.
Materials and methods A retrospective analysis was conducted on 481 individuals who underwent colonoscopy from June 2023 to December 2024. Data collected included demographic characteristics, comorbidities, smoking history, and colonoscopy findings. Multivariable logistic regression was used to identify independent predictors of neoplastic polyps and CRC.
Results Among the 481 individuals who underwent colonoscopy, 453 patients were included in the final analysis, with 28 patients excluded due to incomplete data. Among these, 25.6% had precancerous colorectal lesions, and 3.31% were diagnosed with colorectal cancer (CRC). Multivariable logistic regression identified male gender (adjusted odds ratio [aOR] 2.08, 95% CI: 1.25–3.45, P=0.005), smoking (aOR = 3.66, 95% CI: 1.76–7.59, P<0.001), hyperlipidemia (aOR = 1.73, 95% CI: 1.01–2.97, P=0.047), and increasing age (aOR per year = 1.03, 95% CI: 1.01–1.06, P=0.004) as independent predictors of precancerous lesions. For CRC, independent predictors included smoking (aOR = 11.2, 95% CI: 2.49–50.27, P=0.002), hematochezia or change in bowel habits (aOR = 17.66, 95% CI: 4.76–65.53, P<0.001), and American Society of Anesthesiologists (ASA) Physical Status Classification Class 3 (aOR = 7.71, 95% CI: 1.52–39.14, P=0.014).
Conclusions Precancerous colorectal lesions and colorectal cancer were significantly associated with modifiable and demographic risk factors. Male gender, smoking, hyperlipidemia, and advancing age were identified as independent predictors of precancerous lesions, while smoking, lower bowel symptoms, and higher ASA classification were strongly associated with colorectal cancer. These findings support the implementation of risk-based screening strategies, particularly in resource-limited settings, and underscore the clinical value of symptom-driven colonoscopy in early CRC detection.
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