Gender Differences between Patients with Colorectal Adenoma, Intramucosal Cancer, and Invasive Cancer Detected by Colonoscopy

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  • Kimura Seiji
    Division of Internal Medicine, Sannohe Municipal Hospital
  • Tanaka Masanori
    Department of Pathology and Laboratory Medicine, Hirosaki City Hospital
  • Kudoh Toshihiro
    Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine
  • Aizawa Hiroshi
    Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine
  • Fukuda Shinsaku
    Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine

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  • 当施設の大腸内視鏡における腺腫，粘膜内癌，浸潤癌別に比較した男女差の検討

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Abstract

Women have a higher incidence of colorectal cancer in older ages and have a greater number of proximal cancers compared to men. In order to evaluate these phenomena we analyzed gender differences between patients with colorectal adenoma, intramucosal cancer, and invasive cancer. A total of 1,004 patients with pathologically evaluated colorectal neoplasms during colonoscopy was included in the study. They consisted of 598 with adenoma(s) only (group A), 185 with at least one intramucosal cancer (group B), and 221 with at least one invasive cancer (group C). In groups A, B, and C the statistical comparisons between male and female were made with regard to the mean age, the proportion of patient number, and the proportion between proximal and distal colon neoplasms divided at the junction of the sigmoid-descending colon. Overall, 638 male (63.6%) and 366 female (36.5%) patients were identified, and females (69.2±10.2 yr) were older than males (65.0±10.4 yr) (p<0.0001). The mean ages in each group were 63.3 yr (male) and 67.6 yr (female) in group A, 66.2 yr and 70.1 yr in group B, and 68.5 yr and 71.8 yr in group C, respectively. Females were older than males in all groups (p<0.05). The proportions of patient number between groups A, B, and C were 60.7%: 19.4%: 19.9% in males and 57.6%: 16.7%: 25.7% in females. Females were more likely to have invasive cancer than males (p<0.05), although females with adenoma and/or mucosal cancer were less frequent. The proportions between proximal and distal neoplasms were 48.3%: 51.7% (male), 48.8%: 51.2% (female) in group A, 37.0%: 62.9%, 41.0%: 59.0% in group B, and 29.1%: 70.9%, 43.6%: 56.4% in group C, respectively. Progression from adenoma to invasive cancer led to a distal shift of neoplasms only in males (p<0.0005), although the same shift was not evident in females. In conclusion, a full colonoscopy to examine the deeper region of the colon is essential especially to detect proximal invasive cancer particularly in elderly females.<br>

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