ความชุกและปัจจัยที่มีความสัมพันธ์ต่อการเกิดติ่งเนื้อชนิดเสี่ยงสูงของลำไส้ใหญ่และลำไส้ตรงในกลุ่มผู้ป่วยที่พบเลือดแฝงในอุจจาระ ณ โรงพยาบาลโพธาราม จังหวัดราชบุรี

Piyapat Chungsamanukool

Authors

Piyapat Chungsamanukool Photharam Hospital

Keywords:

Colon polyp, Fecal occult blood, Advanced adenoma

Abstract

Objective: To determine the prevalence and factors associated with advanced adenoma among patients with a positive fecal immunochemical test (FIT) at Photharam Hospital

Methods: This cross-sectional study was conducted at Photharam Hospital, Ratchaburi Province, Thailand, between January 1 and December 31, 2025. Participants were adults aged 50–75 years with a positive FIT result who subsequently underwent colonoscopy. A total of 139 patients were included in the final analysis after excluding patients with incomplete colonoscopy and those diagnosed with colorectal cancer.

Results: Among 2,047 individuals who participated in the FIT-based colorectal cancer screening program, 260 had positive FIT results. Of these, 149 patients (57.3%) underwent colonoscopy. After exclusions, 139 patients were included in the analysis. Colonoscopic findings revealed advanced adenoma in 36 patients (25.9%), non-advanced adenoma in 10 patients (7.2%), and normal findings in 68 patients (48.9%). Multivariate logistic regression analysis demonstrated that anemia (adjusted OR = 6.92, 95% CI: 2.38–20.14; p < .001), age ≥60 years (adjusted OR = 3.36, 95% CI: 1.15–9.75; p = .03), and male sex (adjusted OR = 3.06, 95% CI: 1.16–8.12; p = .02) were independently associated with advanced adenoma. Alcohol consumption, comorbidities, and family history of colorectal cancer were not significantly associated with advanced adenoma.

Conclusion: The prevalence of advanced adenoma among FIT-positive individuals was 25.9%. Anemia, age ≥60 years, and male sex were independently associated with advanced adenoma. These findings can help prioritize colonoscopies by identifying FIT-positive patients at an elevated risk for advanced colorectal neoplasia.

References

Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–63. doi: 10.3322/caac.21834.

International Agency for Research on Cancer. Cancer tomorrow: Estimated number of new cases from 2022 to 2045, both sexes, age [0-85+] all cancers [internet]. 2024 [cited 2024 Jun]. Available from: URL: https://gco.iarc.fr/tomorrow/en/dataviz/bars?populations=764

Dekker E, van Gulik T. Colorectal cancer: What the clinician wants to know. Cancer Imaging. 2005;5(Spec No A):S127–32. doi: 10.1102/1470-7330.2005.0036

Shaukat A, Goffredo P, Wolf JM, Rudser K, Church TR. Advanced adenoma and long-term risk of colorectal cancer, cancer-related mortality, and mortality. JAMA Netw Open. 2025;8(2):e2459703. doi:10.1001/jamanetworkopen.2024.59703

Tiankanon K, Aniwan S, Rerknimitr R. Current status of colorectal cancer and its public health burden in Thailand. Clin Endosc. 2021;54(4):499–504. doi: 10.5946/ce.2020.245-IDEN

Liem B, Gupta N. Adenoma detection rate: The perfect colonoscopy quality measure or is there more? Transl Gastroenterol Hepatol. 2018;3:19. doi: 10.21037/tgh.2018.03.04

Yakoubovitch S, Zaki T, Anand S, Pecoriello J, Liang PS. Effect of behavioral interventions on the uptake of colonoscopy for colorectal cancer screening: A systematic review and meta-analysis. Am J Gastroenterol. 2023;118(10):1829–40. doi: 10.14309/ajg.0000000000002478.

Kim NH, Suh JY, Park JH, Park DI, Cho YK, Sohn CI, et al. Parameters of glucose and lipid metabolism affect the occurrence of colorectal adenomas detected by surveillance colonoscopies. Yonsei Med J. 2017;58(2):347–54. doi: 10.3349/ymj.2017.58.2.347.

Wachirametharat C. Organized colorectal cancer screening in Roi-Et province. Thai Cancer J. 2018;38(1):11–8.

Siripongpreeda B, Mahidol C, Dusitanond N, Sriprayoon T, Muyphuag B, Sricharunrat T, et al. High prevalence of advanced colorectal neoplasia in the Thai population: A prospective screening colonoscopy of 1,404 cases. BMC Gastroenterology [internet]. 2016;16(1). Available from: URL: https://dx.doi.org/10.1186/s12876-016-0526-0

Brenner H, Hoffmeister M, Stegmaier C, Altenhofen L, Haug U, Pox C. Risk of progression of advanced adenomas to colorectal cancer by age and sex: Estimates based on 840,149 screening colonoscopies. Gut. 2007;56(11):1585–9. doi: 10.1136/gut.2007.122739.

Shapero TF, Chen GI, Devlin T, Gibbs A, Murray IC, Tran S, et al. Obesity increases prevalence of colonic adenomas at screening colonoscopy: A Canadian community-based study. Can J Gastroenterol Hepatol. 2017;2017:1–8. doi: 10.1155/2017/8750967.

Pham J, Laven-Law G, Symonds EL, Wassie MM, Cock C, Winter JM. Faecal immunochemical tests can improve colonoscopy triage in patients with iron deficiency: A systematic review and meta-analysis. Crit Rev Oncol Hematol. 2024;201:104439.