A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort

Abstract The prevalence of colorectal adenoma and advanced adenoma (AA) differs between sexes. Also, the optimal age for the first screening colonoscopy is under debate. We, therefore, performed a sex-specific and age-adjusted comparison of adenoma, AA and advanced neoplasia (AN) rates in a real-wor...

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Autores principales:	Sarah Wernly, Bernhard Wernly, Georg Semmler, Sebastian Bachmayer, David Niederseer, Felix Stickel, Ursula Huber-Schönauer, Elmar Aigner, Christian Datz
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b4d036384ade4222942032d85e8a7896
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spelling	oai:doaj.org-article:b4d036384ade4222942032d85e8a78962021-12-02T19:12:27ZA sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort10.1038/s41598-021-97163-02045-2322https://doaj.org/article/b4d036384ade4222942032d85e8a78962021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97163-0https://doaj.org/toc/2045-2322Abstract The prevalence of colorectal adenoma and advanced adenoma (AA) differs between sexes. Also, the optimal age for the first screening colonoscopy is under debate. We, therefore, performed a sex-specific and age-adjusted comparison of adenoma, AA and advanced neoplasia (AN) rates in a real-world screening cohort. In total, 2824 asymptomatic participants between 45- and 60-years undergoing screening colonoscopy at a single-centre in Austria were evaluated. 46% were females and mean age was 53 ± 4 years. A propensity score for being female was calculated, and adenoma, AA and AN detection rates evaluated using uni- and multivariable logistic regression. Sensitivity analyses for three age groups (group 1: 45 to 49 years, n = 521, 41% females, mean age 47 ± 1 years; group 2: 50 to 54 years, n = 1164, 47% females, mean age 52 ± 1 years; group 3: 55 to 60 years, n = 1139, 46% females, mean age 57 ± 2 years) were performed. The prevalence of any adenoma was lower in females (17% vs. 30%; OR 0.46, 95% CI 0.38–0.55; p < 0.001) and remained so after propensity score adjustment for baseline characteristics and lifestyle factors (aOR 0.52, 95% CI 0.41–0.66; p < 0.001). The same trend was seen for AA with a significantly lower prevalence in females (3% vs. 7%; OR 0.38, 95% CI 0.26–0.55; p < 0.001) that persisted after propensity score adjustment (aOR 0.54, 95% CI 0.34–0.86; p = 0.01). Also, all age-group sensitivity analyses showed lower adenoma, AA and AN rates in females. Similar numbers needed to screen to detect an adenoma, an AA or AN were found in female age group 3 and male age group 1. Colorectal adenoma, AA and AN were consistently lower in females even after propensity score adjustment and in all age-adjusted sensitivity analyses. Our study may add to the discussion of the optimal age for initial screening colonoscopy which may differ between the sexes.Sarah WernlyBernhard WernlyGeorg SemmlerSebastian BachmayerDavid NiederseerFelix StickelUrsula Huber-SchönauerElmar AignerChristian DatzNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sarah Wernly Bernhard Wernly Georg Semmler Sebastian Bachmayer David Niederseer Felix Stickel Ursula Huber-Schönauer Elmar Aigner Christian Datz A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort
description	Abstract The prevalence of colorectal adenoma and advanced adenoma (AA) differs between sexes. Also, the optimal age for the first screening colonoscopy is under debate. We, therefore, performed a sex-specific and age-adjusted comparison of adenoma, AA and advanced neoplasia (AN) rates in a real-world screening cohort. In total, 2824 asymptomatic participants between 45- and 60-years undergoing screening colonoscopy at a single-centre in Austria were evaluated. 46% were females and mean age was 53 ± 4 years. A propensity score for being female was calculated, and adenoma, AA and AN detection rates evaluated using uni- and multivariable logistic regression. Sensitivity analyses for three age groups (group 1: 45 to 49 years, n = 521, 41% females, mean age 47 ± 1 years; group 2: 50 to 54 years, n = 1164, 47% females, mean age 52 ± 1 years; group 3: 55 to 60 years, n = 1139, 46% females, mean age 57 ± 2 years) were performed. The prevalence of any adenoma was lower in females (17% vs. 30%; OR 0.46, 95% CI 0.38–0.55; p < 0.001) and remained so after propensity score adjustment for baseline characteristics and lifestyle factors (aOR 0.52, 95% CI 0.41–0.66; p < 0.001). The same trend was seen for AA with a significantly lower prevalence in females (3% vs. 7%; OR 0.38, 95% CI 0.26–0.55; p < 0.001) that persisted after propensity score adjustment (aOR 0.54, 95% CI 0.34–0.86; p = 0.01). Also, all age-group sensitivity analyses showed lower adenoma, AA and AN rates in females. Similar numbers needed to screen to detect an adenoma, an AA or AN were found in female age group 3 and male age group 1. Colorectal adenoma, AA and AN were consistently lower in females even after propensity score adjustment and in all age-adjusted sensitivity analyses. Our study may add to the discussion of the optimal age for initial screening colonoscopy which may differ between the sexes.
format	article
author	Sarah Wernly Bernhard Wernly Georg Semmler Sebastian Bachmayer David Niederseer Felix Stickel Ursula Huber-Schönauer Elmar Aigner Christian Datz
author_facet	Sarah Wernly Bernhard Wernly Georg Semmler Sebastian Bachmayer David Niederseer Felix Stickel Ursula Huber-Schönauer Elmar Aigner Christian Datz
author_sort	Sarah Wernly
title	A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort
title_short	A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort
title_full	A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort
title_fullStr	A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort
title_full_unstemmed	A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort
title_sort	sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b4d036384ade4222942032d85e8a7896
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A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort

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