AimThe English Bowel Cancer Screening Programme detects colorectal cancers and premalignant polyps in a faecal occult blood test‐positive population. The aim of this work is to describe the detection rates and characteristics of adenomas within the programme, identify predictive factors influencing the presence or absence of carcinoma within adenomas and identify the factors predicting the presence of advanced colonic neoplasia in different colon segments.MethodThe Bowel Cancer Screening System was retrospectively searched for polyps detected during colonoscopies between June 2006 and June 2012, at which time a guaiac test was being used. Data on size, location and histological features were collected, and described. Univariate and multivariate analyses were used to determine the significant factors influencing the development of carcinoma within an adenoma.ResultsA total of 229 419 polyps were identified; after exclusions 136 973 adenomas from 58 334 patients were evaluated. Over half were in the rectum or sigmoid colon. Subcentimetre adenomas accounted for 69.8% of the total. The proportion of adenomas containing advanced histological features increased with increasing adenoma size up to 35 mm, then plateaued. A focus of carcinoma was found in 2282 (1.7%) adenomas, of which 95.6% were located distally. Carcinoma was identified even in diminutive adenomas (0.1%). The proportion of adenomas containing cancer was significantly higher in women than men (2.0% vs. 1.5%, p < 0.001).ConclusionThis national, prospectively captured dataset adds robust information about histological features of adenomas that convey an increased risk for colorectal cancer, and identifies caecal adenomas, high‐grade dysplasia, increasing adenoma size, distal location and female sex as independent risk factors associated with carcinoma.

中文翻译：

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英国肠癌筛查计划中的腺瘤特征

目的英国肠癌筛查计划在粪便潜血测试阳性人群中检测结直肠癌和癌前息肉。这项工作的目的是描述该计划内腺瘤的检出率和特征，确定影响腺瘤内是否存在癌症的预测因素，并确定预测不同结肠段中存在晚期结肠肿瘤的因素。筛查系统对 2006 年 6 月至 2012 年 6 月期间结肠镜检查期间检测到的息肉进行了回顾性搜索，当时使用了愈创木脂测试。收集并描述了有关大小、位置和组织学特征的数据。采用单变量和多变量分析确定影响腺瘤内癌发生的显着因素。结果共鉴定出229 419个息肉；排除后，对来自 58,334 名患者的 136,973 个腺瘤进行了评估。超过一半位于直肠或乙状结肠。亚厘米级腺瘤占总数的69.8%。含有高级组织学特征的腺瘤比例随着腺瘤大小增加至 35 毫米而增加，然后趋于稳定。2282 个（1.7%）腺瘤中发现癌灶，其中 95.6% 位于远端。即使在微小腺瘤中也发现了癌（0.1%）。女性中含有癌症的腺瘤比例显着高于男性（2.0% vs. 1.5%，p< 0.001）。结论这个全国性的前瞻性数据集增加了有关腺瘤组织学特征的可靠信息，这些特征表明结直肠癌风险增加，并将盲肠腺瘤、高度异型增生、腺瘤大小增大、远端位置和女性性别确定为独立危险因素与癌有关。