PREVALENCE OF COLORECTAL POLYPS IN SYMPTOMATIC PATIENTS AT A KWAZULU-NATAL REGIONAL HOSPITAL omarsaeed92@gmail.com

 

PREVALENCE OF COLORECTAL POLYPS IN SYMPTOMATIC PATIENTS AT A KWAZULU-NATAL REGIONAL HOSPITAL

1

South Africa

Oral only

Colorectal cancer (CRC) is a leading cause of morbidity and mortality, arising from the adenoma–carcinoma sequence. Background: Colonoscopy is central to prevention, with adenoma detection rate (ADR) a key quality indicator. Limited South African data exist, particularly from regional hospitals. Objectives: To describe the prevalence and characteristics of adenomas in symptomatic patients undergoing colonoscopy at a regional hospital in KwaZulu-Natal, and to assess factors associated with adenoma detection.

A retrospective chart review was conducted at a Durban regional hospital. All adult patients undergoing colonoscopy (Jan 2023–Aug 2024) were included. Demographic, clinical, endoscopic, and histological data were analysed. ADR, advanced adenoma rates, and logistic regression predictors were assessed.

A total of 1 146 patients were analysed (mean age 54; 50.3% male; 53% African, 44% Indian). Rectal bleeding was the top indication (46.5%). The overall ADR was 10.9%. Caecal intubation rate (CIR) was 71.3%. Of 125 patients with adenomas, 32 (25.6%) had advanced adenomas (2.8% overall prevalence). Left-sided lesions predominated (56.8%). On multivariate analysis, only successful caecal intubation was independently protective against missed adenomas (aOR 0.603, p=0.011).

The ADR in this symptomatic cohort was critically below benchmarks. Incomplete caecal intubation and suboptimal bowel preparation are key drivers of this quality gap. Findings highlight the urgent need to strengthen quality metrics (bowel prep, endoscopist training, withdrawal time). This gap implies a significant risk of post-colonoscopy colorectal cancer, making quality improvement critical for CRC prevention in South Africa.