Background & Aims

Despite the availability of endoscopic therapy, many patients in the United States undergo surgical resection for nonmalignant colorectal polyps. We aimed to quantify and examine trends in the use of surgery for nonmalignant colorectal polyps in a nationally representative sample.

Methods

We analyzed data from the Healthcare Cost and Utilization Project National Inpatient Sample for 2000 through 2014. We included all adult patients who underwent elective colectomy or proctectomy and had a diagnosis of either nonmalignant colorectal polyp or colorectal cancer. We compared trends in surgery for nonmalignant colorectal polyps with surgery for colorectal cancer and calculated age, sex, race, region, and teaching status/bed-size–specific incidence rates of surgery for nonmalignant colorectal polyps.

Results

From 2000 through 2014, there were 1,230,458 surgeries for nonmalignant colorectal polyps and colorectal cancer in the United States. Among those surgeries, 25% were performed for nonmalignant colorectal polyps. The incidence of surgery for nonmalignant colorectal polyps has increased significantly, from 5.9 in 2000 to 9.4 in 2014 per 100,000 adults (incidence rate difference, 3.56; 95% confidence interval 3.40–3.72), while the incidence of surgery for colorectal cancer has significantly decreased, from 31.5 to 24.7 surgeries per 100,000 adults (incidence rate difference, –6.80; 95% confidence interval –7.11 to –6.49). The incidence of surgery for nonmalignant colorectal polyps has been increasing among individuals age 20 to 79, in men and women and including all races and ethnicities.

Conclusions

In an analysis of a large, nationally representative sample, we found that surgery for nonmalignant colorectal polyps is common and has significantly increased over the past 14 years.

中文翻译：

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在美国，非恶性大肠息肉患者的手术率不断提高

背景与目标

尽管可以使用内窥镜治疗，但在美国，许多患者仍因非恶性大肠息肉而接受手术切除。我们旨在量化和检查全国代表性样本中非恶性大肠息肉的手术使用趋势。

方法

我们分析了《医疗费用与利用项目国家住院病人样本》（2000年至2014年）的数据。我们纳入了所有接受了择期结肠切除术或直肠切除术且诊断为非恶性大肠息肉或大肠癌的成年患者。我们将非恶性大肠息肉的手术趋势与大肠癌的手术趋势进行了比较，并计算了非恶性大肠息肉的年龄，性别，种族，区域和教学状况/床位比发生率。

结果

从2000年到2014年，美国有1,230,458例针对非恶性大肠息肉和大肠癌的手术。在这些手术中，有25％进行了非恶性大肠息肉手术。非恶性大肠息肉的手术发生率显着增加，从2000年的5.9每100,000名成年人增加至9.4个（2014年发病率差异3.56； 95％置信区间3.40–3.72），而大肠癌的手术发生率显着下降，从每10万名成年人31.5到24.7例手术（发生率差异，–6.80； 95％置信区间–7.11至–6.49）。非恶性大肠息肉的手术发生率在20岁至79岁之间的男性和女性（包括所有种族和种族）中呈上升趋势。

结论

在对全国代表性的大型样本进行的分析中，我们发现非恶性大肠息肉的手术很普遍，并且在过去的14年中明显增加。